Patten, Christi A.; Enoch, Carrie; Renner, Caroline C.; Offord, Kenneth P.; Nevak, Caroline; Kelley, Stacy F.; Thomas, Janet; Decker, Paul A.; Hurt, Richard D.; Lanier, Anne; Kaur, Judith S.
Tobacco cessation interventions developed for Alaska Native adolescents do not exist. This study employed focus group methodology to explore preferences for tobacco cessation interventions and barriers to participation among 49 Alaska Natives (61% female) with a mean age of 14.6 (SD = 1.6) who resided in western Alaska. Using content analysis, themes from the 12 focus groups were found to be consistent across village, gender, and age groups. Program location or site (e.g., away from the village, hunting, fishing), a group-based format, and inclusion of medication and personal stories were reported to be important attributes of cessation programs. Motivators to quit tobacco were the perceived adverse health effects of tobacco, improved self-image and appearance, and the potential to be a future role model as a non–tobacco user for family and friends. Parents were perceived as potentially supportive to the adolescent in quitting tobacco. The findings will be used to develop tobacco cessation programs for Alaska Native youth. PMID:18048549
Liu, Sherry T.; Nemeth, Julianna M.; Klein, Elizabeth G.; Ferketich, Amy K.; Kwan, Mei-Po; Wewers, Mary Ellen
The recent growth in smokeless tobacco (ST) consumption has raised questions about consumer risk perceptions of ST products, especially in high-risk vulnerable populations. This qualitative study examined risk perceptions of ST among adolescent and adult users and non-users in Ohio Appalachia. Focus groups and interviews were held with adolescents (n=53; mean age of 17 years) and adults (n=63; mean age of 34 years) from four Ohio Appalachian counties. Participants were asked about their perceptions of ST-related health risks, ST safety, and the relative safety of ST compared to cigarettes. Transcriptions were coded independently by two individuals. Overall, participants were knowledgeable about health problems from ST use (e.g., oral cancers, periodontal disease). Nearly all participants stated that ST use is not safe; however, there was disagreement about its relative safety. Some perceived all tobacco products as equally harmful; others believed that ST is safer than cigarettes for either the user or those around the user. Disagreements about ST relative safety may reflect mixed public health messages concerning the safety of ST. Comprehensive consumer messages about the relative safety of ST compared to cigarettes are needed. Messages should address the effect of ST on the health of the user as well as those exposed to the user. PMID:25832126
Patten, Christi A.; Enoch, Carrie; Renner, Caroline C.; Offord, Kenneth P.; Nevak, Caroline; Kelley, Stacy F.; Thomas, Janet; Decker, Paul A.; Hurt, Richard D.; Lanier, Anne; Kaur, Judith S.
Tobacco cessation interventions developed for Alaska Native adolescents do not exist. This study employed focus group methodology to explore preferences for tobacco cessation interventions and barriers to participation among 49 Alaska Natives (61% female) with a mean age of 14.6 (SD = 1.6) who resided in western Alaska. Using content analysis,…
Larsen, E; Rise, J; Lund, K E
The use of snus is increasing in Norway. In this study we examined differences between adolescents who were exclusive snus users, and adolescent non-users, smokers and dual users of snus and cigarettes on a number of psychosocial factors, categorized as risk variables and protective variables associated with involvement in health compromising behavior. We applied separate logistic regression models, where exclusive snus users (n=740) were compared with non-users (n=904), smokers (n=219), and dual users (n=367). Compared to non-users, the group of exclusive snus users was associated with variables traditionally predicting health risk behavior, such as smoking friends (OR=1.74, SD 1.27-2.38) and truancy (OR=2.12, SD 1.65-2.78). Compared to smokers, exclusive snus users were related to variables traditionally associated with protection against involvement in health risk behavior, e.g. higher academic orientation (OR=1.66, SD 1.12-2.45). Associations with protective factors were also observed when exclusive snus users were compared with dual users. While the group of exclusive snus users was associated with a pattern of psychosocial risk compared to non-users, they showed a more conventional pattern when compared to smokers and dual users. The group of exclusive snus users may be described on a continuum varying from psychosocial risk factors to protective factors of risk involvement depending on the group of comparison.
Whitehead, Todd P; Havel, Christopher; Metayer, Catherine; Benowitz, Neal L; Jacob, Peyton
Smokeless tobacco products, such as moist snuff or chewing tobacco, contain many of the same carcinogens as tobacco smoke; however, the impact on children of indirect exposure to tobacco constituents via parental smokeless tobacco use is unknown. As part of the California Childhood Leukemia Study, dust samples were collected from 6 homes occupied by smokeless tobacco users, 6 homes occupied by active smokers, and 20 tobacco-free homes. To assess children's potential for exposure to tobacco constituents, vacuum-dust concentrations of five tobacco-specific nitrosamines, including N'-nitrosonornicotine [NNN] and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone [NNK], as well as six tobacco alkaloids, including nicotine and myosmine, were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). We used generalized estimating equations derived from a multivariable marginal model to compare levels of tobacco constituents between groups, after adjusting for a history of parental smoking, income, home construction date, and mother's age and race/ethnicity. The ratio of myosmine/nicotine was used as a novel indicator of the source of tobacco contamination, distinguishing between smokeless tobacco products and tobacco smoke. Median dust concentrations of NNN and NNK were significantly greater in homes with smokeless tobacco users compared to tobacco-free homes. In multivariable models, concentrations of NNN and NNK were 4.8- and 6.9-fold higher, respectively, in homes with smokeless tobacco users compared to tobacco-free homes. Median myosmine/nicotine ratios were lower in homes with smokeless tobacco users (1.8%) compared to homes of active smokers (7.7%), confirming that cigarette smoke was not the predominant source of tobacco constituents in homes with smokeless tobacco users. Children living with smokeless tobacco users may be exposed to carcinogenic tobacco-specific nitrosamines via contact with contaminated dust and household surfaces.
Santana, Yolanda; Gonzalez, Beatriz; Pinilla, Jaime; Calvo, Jose Ramon; Barber, Patricia
Background: In adolescents aged 12-14, we measured attitudes to tobacco advertising. Our purpose is to understand the relation of these attitudes to tobacco use and identify the groups most influenced by the advertising. Methods: Survey of adolescents on Gran Canaria Island, Spain, about aspects of family, school, peers, tobacco consumption, and…
Alvarez-Aguirre, Alicia; Alonso-Castillo, María Magdalena; Zanetti, Ana Carolina Guidorizzi
OBJECTIVES: to analyze the effect of self-esteem, assertiveness, self-efficacy and resiliency on alcohol and tobacco consumption in adolescents. METHOD: a descriptive and correlational study was undertaken with 575 adolescents in 2010. The Self-Esteem Scale, the Situational Confidence Scale, the Assertiveness Questionnaire and the Resiliency Scale were used. RESULTS: the adjustment of the logistic regression model, considering age, sex, self-esteem, assertiveness, self-efficacy and resiliency, demonstrates significance in the consumption of alcohol and tobacco. Age, resiliency and assertiveness predict alcohol consumption in the lifetime and assertiveness predicts alcohol consumption in the last year. Similarly, age and sex predict tobacco consumption in the lifetime and age in the last year. CONCLUSION: this study can offer important information to plan nursing interventions involving adolescent alcohol and tobacco users. PMID:25591103
Oslash-Verland, Simon; Aaro, Leif Edvard; Lindbak, Rita Lill
Schools are an important arena for smoking prevention. In many countries, smoking rates have been reduced among adolescents, but the use of smokeless tobacco is on the rise in some of these countries. We aimed to study the associations between schools' restrictions on smoking and snus and on the use of these tobacco products among students in…
Veeranki, Sreenivas P; Mamudu, Hadii M; John, Rijo M; Ouma, Ahmed E O
Approximately 90% of adults start smoking during adolescence, with limited studies conducted in low-and-middle-income countries where over 80% of global tobacco users reside. The study aims to estimate prevalence and identify predictors associated with adolescents' tobacco use in Madagascar. We utilized tobacco-related information of 1184 school-going adolescents aged 13-15 years, representing a total of 296,111 youth from the 2008 Madagascar Global Youth Tobacco Survey to determine the prevalence of tobacco use. Gender-wise multivariable logistic regression models were conducted to identify key predictors. Approximately 19% (30.7% males; 10.2% females) of adolescents currently smoke cigarettes, and 7% (8.5% males and 5.8% females) currently use non-cigarette tobacco products. Regardless of sex, peer smoking behavior was significantly associated with increased tobacco use among adolescents. In addition, exposures to tobacco industry promotions, secondhand smoke (SHS) and anti-smoking media messages were associated with tobacco use. The strong gender gap in the use of non-cigarette tobacco products, and the role of peer smoking and industry promotions in adolescent females' tobacco use should be of major advocacy and policy concern. A comprehensive tobacco control program integrating parental and peer education, creating social norms, and ban on promotions is necessary to reduce adolescents' tobacco use.
Morgan, B J
This study evaluated the short-term effect of a one-time tobacco hazard education intervention on tobacco use and intention to quit among military tobacco users. Of the 151 Army infantry soldiers who received the intervention, 60 (40%) participated in a 1-month follow-up survey. Respondents' reported pre-intervention tobacco habits included 51% smoking, 22% smokeless tobacco use, and 27% both. A one-group, posttest-only design demonstrated a decline in tobacco use in more than half of tobacco users: 14% quit, and 37% decreased use. However, 46% stayed the same, and 3% increased use. A statistically significant difference in tobacco use existed among the three subgroups of tobacco users (p = 0.004). Smokeless-tobacco-only users were more likely to quit than smoking-only or combined users. Eighty percent had positive thoughts or actions toward quitting tobacco use after the intervention. Results suggest that a one-time tobacco education intervention can positively influence tobacco use in the short term and motivate tobacco users toward quitting.
Donovan, R; Jancey, J; Jones, S
Objectives: To determine the potential impact of point of sale advertising on adolescents so as to inform changes to the Tobacco Control Act. Design: Participants were randomly assigned to one of two conditions. In the control condition, students were exposed to a photograph of a packet of cigarettes; in the intervention condition, students were exposed to an ad for cigarettes, typical of point of sale advertising posters. All students then rated the brand user on a set of 12 bipolar adjectives. Two brands were used in the study: Benson & Hedges, and Marlboro. Subjects: One hundred year (grade) 6 and 7 students (age range 10–12 years), from four Western Australian metropolitan primary schools, participated in the study. Results: In a majority of the brand user descriptions, the cigarette advertisements increased brand user imagery in a positive way, especially for Benson & Hedges. For example, participants viewing the Benson & Hedges advertisement, as distinct from those viewing the Benson & Hedges pack only, were more likely to describe the Benson & Hedges user as relaxed, interesting, cool, rich, adventurous, and classy. Relative to the Marlboro pack only, the Marlboro ad increased positive perceptions of the Marlboro user on adventurous, interesting, and relaxed. Conclusions: The results presented here support restrictions being placed on advertising at point of sale, since such ads have the potential to increase positive brand user imagery directly in the situation where a product purchase can take place, and hence the potential to increase the likelihood of impulse purchasing. PMID:12198267
Campbell-Grossman, Christie; Hudson, Diane Brage; Fleck, Margaret Ofe
The purposes of this pilot study were to describe the incidence of chewing tobacco use among rural midwestern adolescents and to describe rural midwestern adolescents' perceptions and knowledge about chewing tobacco use. A Smokeless Tobacco Use Survey was administered to 34 adolescent subjects who attended 5th-8th grades in two rural towns. None of the subjects reported trying chewing tobacco products. However, a group of male subjects who stated they may chew tobacco sometime in the future, performed less well on the test about chewing tobacco facts and perceptions of use, indicating some education needs are warranted. Risk factors and deterrent factors to using chewing tobacco are reported.
Rice, Virginia Hill; Weglicki, Linda S.; Templin, Thomas; Hammad, Adnan; Jamil, Hikmet; Kulwicki, Anahid
This study examined personal, psychosocial, sociocultural, and environmental predictors in tobacco use for 1,671 Arab American adolescents. Cigarette smoking in the past 30 days was 6.9%. This increased from 1% at age 14 to 14% at age 18. Twenty-nine percent of the youths reported having ever smoked cigarettes. Experimentation with narghile was…
Sargent, James D; DiFranza, Joseph R
Smoking remains the most common preventable cause of death in the developed world, and is rapidly becoming an important cause of death in the developing world. Nicotine is a powerfully addictive substance, and the tobacco industry spends billions annually promoting it in the United States. It is therefore important for clinicians to understand why people smoke, to address smoking in patients of all ages, and to lobby for health-preserving tobacco control policies at the community level. Children take up smoking in response to social influences: smoking by friends, parents, and family, and through exposure to smoking in media. Parents who smoke not only model the behavior, but also often make the product available by leaving cigarettes around the house. Media influences include the dollar 10 billion spent per year on tobacco marketing, but more importantly, the modeling of the behavior on screen by movie and television stars. Once children start smoking, many rapidly lose autonomy over the behavior. Youth can get hooked after smoking just a few cigarettes. The most effective community efforts for reducing tobacco use are: raising the price of tobacco; halting the sale of tobacco to minors; enforcing strict school tobacco policies; and making public places smoke free through local ordinances. Working with individuals, clinicians should support cessation in all smokers, including parents of children and adolescents. They should screen children for smoking risk factors beginning at age 10. They should teach parents to maintain smoke-free households, to set nonsmoking expectations early on, and to monitor adolescents for signs of smoking. Parents should limit exposure to adult media (e.g., R-rated movies) and use family television time to discuss the effect of seeing screen depictions of smoking on adolescent behavior. Adolescents who smoke should be assessed for signs of nicotine dependence and counseled about quitting. Clinicians are effective community voices; they
Webster, Lauren; Chaiton, Michael; Kirst, Maritt
Background: This study explores the patterns of use and co-use of tobacco and cannabis among Ontario adolescents over 3 decades and if characteristics of co-users and single substance users have changed. Methods: Co-use trends for 1981-2011 were analyzed using the Centre for Addiction and Mental Health Ontario Student Drug Use and Health Survey,…
Hecht, Stephen S; Carmella, Steven G; Murphy, Sharon E; Riley, William T; Le, Chap; Luo, Xianghua; Mooney, Marc; Hatsukami, Dorothy K
Smokeless tobacco has been proposed as a reduced risk substitute for smoking, but no large studies have investigated exposure to the powerful carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in smokeless tobacco users versus smokers. The purpose of this study was to carry out such a comparison. Levels of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides (total NNAL), a biomarker of NNK exposure, and cotinine, a biomarker of nicotine exposure, were quantified in the urine of 420 smokers and 182 smokeless tobacco users who were participants in studies designed to reduce their use of these products. The measurements were taken at baseline, before intervention. Levels of total NNAL per milliliter of urine were significantly higher in smokeless tobacco users than in smokers (P < 0.0001). When adjusted for age and gender, levels of total NNAL per milligram of creatinine were also significantly higher in smokeless tobacco users than in smokers (P < 0.001). Levels of cotinine per milliliter of urine and per milligram of creatinine were significantly higher in smokeless tobacco users than in smokers (P < 0.001). These results show similar exposures to the potent tobacco-specific carcinogen NNK in smokeless tobacco users and smokers. These findings do not support the use of smokeless tobacco as a safe substitute for smoking.
This study asks whether representations of different typical tobacco users vary in line with established stereotypes and by social group membership (especially tobacco user status). Social identity theory posits that representations differ due to varying identification with product users on the basis of personal use, while distinction theory suggests representations will be structured by proximity and distance to user groups. Using principal component analysis to identify representations and regression analysis to determine variances in representations, we find that four of five groups of typical tobacco users (snus users, pipe, cigarette, and cigar smokers) can be classified according to three similar representations: socially secure, culturally marginal and unappealing. Respondents who themselves use a certain tobacco product are more likely to consider a 'typical' user from their own group as more 'socially secure' and less 'culturally marginal' and 'unappealing' than non-users. Former smokers tend to side with non-smokers, which suggests their 'smoker identity' is on the wane. At the representational level, then, socio-historical distinctions between different tobacco products seem to have diminished in favour of a largely dual classification, with users expressing positive and non-users negative representations, of any typical user. This is a likely consequence of persistent tobacco denormalisation policies.
Cooper, Maria; Case, Kathleen R.; Loukas, Alexandra; Creamer, MeLisa R.; Perry, Cheryl L.
Objectives We examined differences in the characteristics of youth non-users, cigarette-only, e-cigarette-only, and dual e-cigarette and cigarette users. Methods Using weighted, representative data, logistic regression analyses were conducted to examine differences in demographic characteristics and tobacco use behaviors across tobacco usage groups. Multiple linear regression analyses were conducted to examine differences in harm perceptions of various tobacco products and perceived peer use of e-cigarettes by tobacco usage group. Results Compared to non-users, dual users were more likely to be white, male, and high school students. Dual users had significantly higher prevalence of current use of all products (except hookah) than e-cigarette-only users, and higher prevalence of current use of snus and hookah than the cigarette-only group. Dual users had significantly lower harm perceptions for all tobacco products except for e-cigarettes and hookah as compared to e-cigarette-only users. Dual users reported higher peer use of cigarettes as compared to both exclusive user groups. Conclusion Findings highlight dual users’ higher prevalence of use of most other tobacco products, their lower harm perceptions of most tobacco products compared to e-cigarette-only users, and their higher perceived peer use of cigarettes compared to exclusive users. PMID:26685819
Galanti, Maria Rosaria; Rosendahl, Ingvar; Wickholm, Seppo
Whether the use of smokeless tobacco can facilitate the transition to cigarette smoking and/or to prolonged tobacco use in adolescence is unclear. We analyzed data from a cohort of 2,938 Swedish adolescents, with six follow-up assessments of tobacco use between the ages of 11 and 18 years. The majority of tobacco users (70%) started by smoking cigarettes, 11% took up snus before smoking, and 19% used both tobacco types close in time. Ever users of tobacco at baseline had a higher risk of being current smokers and/or smokeless tobacco users at the end of follow-up compared with never users, with the highest excess relative risk for "mixed users." Adolescents who initiated tobacco use with cigarettes had a non-significantly increased probability to end up as current smokers compared with snus starters (adjusted OR=1.42; 95% CI 0.98-2.10) The OR of smoking for "mixed starters" was 2.54 (95% CI 1.68-3.91). The risk of becoming current user of any tobacco was also significantly enhanced for "mixed starters." Marked sex differences were observed in these associations, as initiation with cigarettes rather than with snus predicted current smoking or tobacco use only among females. Progression of tobacco use in adolescence is not predicted by onset with snus or cigarettes, but rather by initiation with both tobacco types close in time and/or at young age. The proportion of adolescent smoking prevalence attributable to a potential induction effect of snus is likely small.
Schinke, S P; Gilchrist, L D; Schilling, R F; Senechal, V A
Data from a 2-year study describe tobacco use trends, perceptions, and prevention effects for 1,281 5th and 6th graders enrolled in 12 randomly selected Washington State elementary schools. Youths were pretested, then randomly divided by school into skills, discussion, and control groups. Preventive intervention curriculums for the skills and discussion groups included age-relevant information on smoked and smokeless tobacco use, peer testimonials, debates, games, and homework. Youths in the skills group also learned communication and problem-solving methods for handling difficult situations around tobacco use. Following intervention, youths were posttested, then retested semiannually for 2 years. During the 2-year study, three-quarters of all smokers and nonusers and half of all smokeless tobacco users maintained their statuses. Only 10 percent of all smokers and 3 percent of all smokeless users quit their habits. One in six reported new tobacco use, one-third of smokers began using smokeless tobacco, and two-thirds of all smokeless users began smoking during the study. Most youths at final measurement perceived smokeless tobacco as less of a health risk than smoking. Nearly one in two of all smokeless users intended to smoke, and two-thirds were actually smoking at 24-month followup. Both smoked and smokeless tobacco use rates increased in all groups, and youths in the skills intervention group consistently showed the lowest rates relative to the other groups. These findings demonstrate the potential of skills intervention methods for lowering tobacco use rates among adolescents. PMID:3090603
Murphey, David; Barry, Megan; Vaughn, Brigitte; Terzian, Mary
Cigarette smoking has steadily declined among adolescents during the last fifteen years, although use of some tobacco products, like cigars, has seen recent increases. However, large numbers of teens continue to use tobacco products. This "Adolescent Health Highlight" presents key research findings; describes prevalence and trends; illustrates…
Newman, Ian M.
This report on adolescent tobacco use in Nebraska focuses on grades 8 and 10. The results presented are based on over time; (2) the changing nature of tobacco use from smoking to use as a chew or snuff; (3) the viewing of smoking and chewing as one health issue of tobacco exposure; (4) definition of a smoker for purposes of this study; (5) data…
Singh, Tushar; Kennedy, Sara M.; Sharapova, Saida S.; Schauer, Gillian L.; Rolle, Italia V.
Background Tobacco and marijuana use are related behaviors; therefore, it is important to identify how users consume marijuana, and how it varies with tobacco use status. We estimated the modes of ever marijuana use among current, former, and never adult tobacco users. Methods Weighted data were analyzed for 4181 adults from 2014 Styles, an online consumer panel survey of US adults, to estimate proportions for modes of ever marijuana use. Differences in modes of ever marijuana use between categories of tobacco use status were assessed (p-value <0.05). Results More than half of current (56.6%) and former tobacco users (50.9%) had ever used marijuana, whereas only 13.0% of never tobacco users had ever used marijuana. Among ever marijuana users, joint use was the most common mode of use among current (86.4%), former (92.5%), and never (79.8%) tobacco users. Similarly, other modes of marijuana use were significantly higher in current and former tobacco users compared to never tobacco users. Conclusions Prevalence of all modes of ever marijuana use was higher in current and former tobacco users. These findings underscore the importance of considering the relationship between marijuana and tobacco use when developing programs and policies aimed at preventing and reducing marijuana use. PMID:27840591
Mejia, Adrienne B.
Since 2006, RJ Reynolds (RJR) and Philip Morris have both introduced new smokeless “snus” tobacco products. We analyzed previously secret tobacco industry documents describing the history of RJR and Philip Morris's consumer research, smokeless product development, and marketing strategies. We found that RJR had invested in smokeless research, development, and marketing since 1968. RJR first targeted low-income males through sampling and sponsorship at fishing, rodeo, and baseball events, and through advertising portraying the user as “hard working.” In the early 1990s, Philip Morris and RJR hoped to attract more urban, female smokeless users. The current “snus” campaigns appear to appeal to these targeted consumers and smokers in smoke-free environments. These efforts may expand the tobacco market and undermine smoking cessation. PMID:19910355
Mejia, Adrienne B; Ling, Pamela M
Since 2006, RJ Reynolds (RJR) and Philip Morris have both introduced new smokeless "snus" tobacco products. We analyzed previously secret tobacco industry documents describing the history of RJR and Philip Morris's consumer research, smokeless product development, and marketing strategies. We found that RJR had invested in smokeless research, development, and marketing since 1968. RJR first targeted low-income males through sampling and sponsorship at fishing, rodeo, and baseball events, and through advertising portraying the user as "hard working." In the early 1990s, Philip Morris and RJR hoped to attract more urban, female smokeless users. The current "snus" campaigns appear to appeal to these targeted consumers and smokers in smoke-free environments. These efforts may expand the tobacco market and undermine smoking cessation.
Atari, Dominic Odwa
Introduction Tobacco use is one of the leading and preventable causes of global morbidities and premature mortalities. The study explores gender differences in the prevalence and determinants of tobacco use among school-aged adolescents (11-17years) in Sudan and South Sudan. Methods The study utilized the national Global Youth Tobacco Survey (GYTS) data collected in 2005 for Sudan (4,277 unweighted; 131,631 weighted). Univariate and bivariate analyses were conducted to examine the associations between the dependent (tobacco use status) and independent variables. Logistic regression analyses were performed to identify the key factors which influence tobacco consumption among adolescents in the 2 Sudans for ever cigarette users, current cigarette users, and users of noncigarette tobacco products. Results There were significant gender differences in the prevalence of ever cigarette users (21.8%; male=13.1%, female=6.5%, p<0.05) and current cigarette users (6.9%; male=4.9%, female = 1.3%, p<0.05) but not among users of noncigarette tobacco products (14.7%; male=6.8%, female=6.1%). Adolescent tobacco use was significantly associated with availability of monthly income or allowance, exposure to tobacco industry promotions, and tobacco-use behavior of familial relations. Knowledge about the harmful effects of secondhand smoke was related with decreased likelihood of tobacco use. Conclusion School programs that focus on health messages alone may not work for the adolescent population. Legislations that ban all types of tobacco advertisements, promotions, and sponsorships among adolescents are needed in the 2 countries. PMID:25404978
Jordan, Timothy R.; Price, James H.; Dake, Joseph A.; Shah, Sapna
Environmental tobacco smoke (ETS) poses an underappreciated risk to adolescent health. This study examined perceptions of adolescents (n = 574) regarding ETS. About one half (54%) were exposed to ETS the previous week, and one third (30%) were exposed to 3 or more hours of ETS the past week. Concurrently, 29% believed that breathing someone else's…
Atkins, Leslie A.; Oman, Roy F.; Vesely, Sara K.; Aspy, Cheryl B.; McLeroy, Kenneth
Surveyed adolescents and their parents regarding the effects of 10 youth developmental assets on adolescent tobacco use. Results highlighted a strong relationship between having any of nine assets and not smoking. Important assets included having adult, parental, and peer role models; family communication; good use of time; religion; effective…
Lara, M. Dolores; Bermudez, Jose; Perez-Garcia, Ana M.
Introduction: Adolescence is a period when at-risk health behaviors often begin, such as tobacco and alcohol use; thus, it is a critical period for implementing preventive strategies. Method: In this context, 106 adolescents took part in this research (54 females and 52 males; mean age for both groups = 14.10). The main objectives were to first…
Huntington-Moskos, Luz; Turner-Henson, Anne; Rice, Marti
The pathogenesis of hypertension begins in youth. An estimated 4% of US adolescents have diagnosed hypertension and 17% have elevated blood pressures, predisposing them to hypertension and cardiovascular disease (CVD) later in life. There is limited research on the clustering of CVD risk factors such as tobacco exposure and weight status that may be associated with high blood pressure in adolescents. The aim of this exploratory study was to determine the relationships between total smoke exposure (TSE; cigarette smoking and secondhand smoke), waist circumference, and blood pressure in a sample of rural adolescents, ages 15-18. A convenience sample of 148 adolescents ages 15-18 was recruited from two rural high schools (88 female and 60 male, all Caucasian). Adolescents were assessed for tobacco exposure (self-report, salivary cotinine), weight status (body mass index, waist circumference), and blood pressure. Self-report measures of tobacco exposure included the Uptake Continuum and Peer and Family Smoking measure. Age, gender, waist circumference and salivary cotinine contributed to 35% of the variance in systolic blood pressure and 18% in diastolic blood pressure. One-fourth (25%) of adolescent males and 11% of adolescent females had elevated systolic blood pressures. Approximately one-fifth of the sample (22%) had elevated salivary cotinine levels indicative of tobacco use and secondhand smoke exposure. TSE and waist circumference were predictors of elevated blood pressure in adolescents. Public health measures need to address clusters of risk factors including blood pressure, tobacco exposure, and weight status among adolescents in order to reduce CVD.
Zanis, David A.; Hollm, Ronald E.; Derr, Daniel; Ibrahim, Jennifer K.; Collins, Bradley N.; Coviello, Donna; Melochick, Jennifer Ryan
Objective: To evaluate 3-month tobacco quit rates of young adult tobacco users randomized to 2 intervention conditions. Methods: Overall 192 non-treatment-seeking 18-to-24-year-old tobacco users received educational information and advice to quit smoking. Participants were then block randomized to 2 brief intervention conditions: (1) a telephone…
Baheiraei, Azam; Soltani, Farzaneh; Ebadi, Abbas; Cheraghi, Mohammad Ali; Foroushani, Abbas Rahimi
Introduction: Family and peer risk factors are considered as important predictors of tobacco use in adolescents. Furthermore, information regarding gender differences in lifetime tobacco use of adolescents is essential for designing gender-specific tobacco prevention policies. Methods: In a cross-sectional population-based study, 870 Iranian adolescents (430 boys and 436 girls) aged 15-18 years old, filled out the adopted form of “Communities That Care Youth Survey”. Four family and two peer risk factors were entered in adjusted logistic regression analyses to predict the lifetime tobacco use (cigarette and smokeless tobacco) in boys and girls, separately. Results: Boys reported higher prevalence of lifetime cigarettes use compared to girls (22.8% vs. 17.8%, p = 0.04). However, the prevalence of lifetime smokeless tobacco use in girls was the same as boys, even slightly higher (7.9% vs. 7.1%, P=0.5). “Family history of drug use” and “Friends use of drugs” were common risk factors predicting cigarettes and smokeless tobacco use between both genders. On the other hand, other family risk factors included “Poor family management”, “Parental attitude favorable toward drug use” and “Family conflict” were the predictors of lifetime tobacco use only in girls, but not in boys. Conclusion: Design and implementation of preventative programs for adolescents tobacco use should be conducted with emphasis on the role of smoker parents at home, and friendship with substance user peers with antisocial behaviors. It seems that family risk factors may have more value in prevention of tobacco use in female adolescents. PMID:24999129
... any product made or derived from tobacco that is intended for human consumption, including any... HUMAN SERVICES Food and Drug Administration 21 CFR Part 1150 RIN 0910-AG81 Tobacco Products, User Fees... of Tobacco Products AGENCY: Food and Drug Administration, HHS. ACTION: Proposed rule. SUMMARY:...
Agaku, Israel T.; Ayo-Yusuf, Olalekan A.
Introduction: This study assessed the influence of exposure to pro-tobacco advertisements on experimentation with emerging tobacco products among U.S. adolescents aged =9 years, in Grades 6 to 12. Method: Data were obtained from the 2011 National Youth Tobacco Survey. Multivariate logistic regression was used to measure the association between…
Couch, Elizabeth T; Darius, Ellen; Walsh, Margaret M; Chaffee, Benjamin W
Smokeless tobacco (ST) use among US high school males living in rural areas exceeds national levels. Subgroups at heightened risk of ST use have been identified, but less is known regarding ST decision-making within high-risk groups. The study objective was to describe rural adolescent males' perceived ST acceptability, health risks, and social implications and how those perceptions differ between ST users and never-users. Semi-structured individual interviews were conducted with a purposeful sample of 55 male students (32 ST ever-users) at three rural California high schools. Interviews were audio recorded and professionally transcribed. Investigators collaboratively developed a codebook based on thematic content and then independently coded transcripts, reconvening frequently to achieve consensus. Coded text was systematically organized into themes following a general inductive approach. ST users and non-users shared multiple ST-related perceptions, including: that ST is a common, normative way of life in rural "country" culture among certain groups; that ST use conveys oral health risks; and that the decision to use (or not to use) is rooted in personal choice. ST users' and never-users' perceptions differed regarding the immediacy, severity, and inevitability of health risks, particularly relative to cigarette smoking. Other differences included perceived parental permissiveness and the expected social benefits of ST use, such as peer acceptance and conveying maturity. Within this population of rural male adolescents, ST users emphasized the social benefits of ST use, while acknowledging but discounting health risks. Differences and similarities in tobacco perceptions among adolescents living in similar environments may inform effective health communication.
Brown, Abraham; Moodie, Crawford
Using cross-sectional data from three waves of the Youth Tobacco Policy Study, which examines the impact of the UK's Tobacco Advertising and Promotion Act (TAPA) on adolescent smoking behaviour, we examined normative pathways between tobacco marketing awareness and smoking intentions. The sample comprised 1121 adolescents in Wave 2 (pre-ban), 1123…
Yadalam, Pradeep K.; Rajapandian, K.; Ravishankar, P. L.; Vartharajan, Kalaivani; Subramaniam, Srinath; Dinakar, Mithra
Aims: Many studies have proven that b2-glycoprotein-I-dependent anticardiolipin is elevated in periodontal diseases. Systemic lupus erythematosus and antiphospholipid syndrome, which are usually associated with high antiphospholipid antibodies, are more prone to adverse pregnancy outcomes and cardiovascular sequelae. Therefore, the aim of the present study is to evaluate IgG, IgM anticardiolipin antibodies in tobacco users and non-tobacco users with severe chronic periodontal disease. Materials and Methods: Based on the Armitage classification, 2000, 40 severe periodontitis (group D) (mean clinical attachment loss greater than 2.5 mm) male patients were selected for the study with the age range of 35–65 years and good general health from the Department of periodontics, SRM Kattankulathur Dental College, Chennai. They were classified as smokers (20 subjects) and non-smokers (20 subjects). Blood samples were collected and IgG, IgM antibodies were semi-quantitatively analyzed by enzyme-linked immunosorbent assay. The data thus collected were statistically analyzed by independent student's t-test. Results: Results showed that smokers with severe periodontitis exhibited marked increase in anticardiolipin IgG, IgM compared to non-smokers. They showed a positive correlation and statistical significance (P < 0.0001) between mean clinical attachment loss and IgG and IgM values. Conclusions: Results showed a rise in anticardiolipin antibodies in smokers with severe periodontitis, which indicates that these patients are more prone to coronary heart disease. PMID:27382544
Kassim, Saba; Jawad, Mohammed; Croucher, Ray; Akl, Elie A.
Khat, an “amphetamine-like green leaf,” may influence the consumption of tobacco. This study reviews the epidemiology of tobacco use among khat users. Electronic database searches using appropriate keywords/terms were conducted to identify observational studies of khat use. Assessment of quality and risk of bias of all included studies was conducted, and the results were synthesised descriptively. Nine eligible cross-sectional studies were identified. All assessed self-reported tobacco among khat users and were carried out in Africa and the Middle East. Eight reported cigarettes and one reported waterpipes as the mode of use. Methods of tobacco use prevalence assessment varied. Prevalence of “current” tobacco use among students and university teachers ranged from 29 to 37%; “lifetime” tobacco use in university teachers was 58% and “undefined” tobacco use in nonspecific adults and students ranged from 17 to 78%. Daily tobacco use among adults was reported as 17% whilst simultaneous tobacco and khat use was reported as between 14 and 30% in students. In conclusion, tobacco prevalence among khat users appears significant. Findings should be interpreted cautiously due to self-reported tobacco use, diversity in questions assessing tobacco use, and type of tobacco consumption. Future research should address the methodological shortcomings identified in this review before appropriate policy interventions can be developed. PMID:26273606
Benowitz, Neal L.; Renner, Caroline C.; Lanier, Anne P.; Tyndale, Rachel F.; Hatsukami, Dorothy K.; Lindgren, Bruce; Stepanov, Irina; Watson, Clifford H.; Sosnoff, Connie S.; Jacob, Peyton
Background The prevalence of tobacco use, both cigarette smoking and smokeless, including iqmik (homemade smokeless tobacco prepared with dried tobacco leaves mixed with alkaline ash), and of tobacco-related cancer is high in Alaskan Native people (AN). To investigate possible mechanisms of increased cancer risk we studied levels of nicotine and tobacco-specific nitrosamines (TSNA) in tobacco products and biomarkers of tobacco toxicant exposure in Southwestern AN people. Methods Participants included 163 cigarette smokers, 76 commercial smokeless tobacco, 20 iqmik, 31 dual cigarette smokers and smokeless tobacco, and 110 nontobacco users. Tobacco use history, samples of tobacco products used, and blood and urine samples were collected. Results Nicotine concentrations were highest in cigarette tobacco and TSNAs highest in commercial smokeless tobacco products. The AN participants smoked on average 7.8 cigarettes per day. Nicotine exposure, assessed by several biomarker measures, was highest in iqmik users, and similar in smokeless tobacco and cigarette smokers. TSNA exposure was highest in smokeless tobacco users, and polycyclic aromatic hydrocarbon exposure was highest in cigarette smokers. Conclusions Despite smoking fewer cigarettes per day, AN cigarette smokers had similar daily intake of nicotine compared to the general U.S. population. Nicotine exposure was greatest from iqmik, likely related to its high pH due to preparation with ash, suggesting high addiction potential compared to other smokeless tobacco products. TSNA exposure was much higher with smokeless tobacco than other product use, possibly contributing to the high rates of oral cancer. Impact Our data contribute to an understanding of the high addiction risk of iqmik use and of the cancer-causing potential of various forms of tobacco use among AN people. PMID:22490317
Al Agili, Dania E.; Park, Hyoun-Kyoung
Background: Adolescent tobacco use has been a serious public health issue, resulting in longer duration of tobacco use and higher nicotine dependence in adulthood. This study identified the current status of tobacco use among middle schools students in Jeddah, Saudi Arabia and the factors leading to tobacco use, to provide information on how to…
Boyle, Raymond G; Enstad, Chris; Asche, Stephen E; Thoele, Merry J; Sherwood, Nancy E
We recruited smokeless tobacco users throughout Minnesota to participate in a trial testing telephone counseling versus a written self-help manual for cessation. This paper describes the recruitment strategies applied on a state-wide basis. We established a recruitment tracking system to monitor weekly rates of screened callers and returned consents, allowing us to adjust future recruitment efforts. Screening was completed with 783 callers, with 406 subjects enrolled. Overall 44% of initial contacts and 52% of those screened enrolled in the study. The overall average cost per consented subject was $99. Sports talk radio, small print ads, and newspaper articles based on press releases were consistently effective channels for recruitment. The overall cost was expensive but reflected the geographic diversity of recruitment and the prevalence of oral snuff use.
Gwon, Seok Hyun; DeGuzman, Pamela B.; Kulbok, Pamela A.; Jeong, Suyong
Adolescent smoking prevention is an important issue in health care. This literature review describes the theoretical concept of ecological model for adolescent smoking and tobacco retailers and summarizes previous studies on the association between the density and proximity of tobacco retailers and adolescent smoking. We reviewed nine studies on…
Thrasher, James F.; Niederdeppe, Jeffrey D.; Jackson, Christine; Farrelly, Matthew C.
Media campaigns to prevent adolescent tobacco use in the United States increasingly focus on the deceitful practices of the tobacco industry; however, little is known about how adolescents at elevated smoking risk respond to this strategy. This study used data from a nationally representative survey of 10,035 adolescents, ages 12-17 years, in…
Andersson, G; Björnberg, G; Curvall, M
The purpose of this study was to investigate the uptake and metabolism of nicotine by smokeless (oral) tobacco users and to find out if the less pronounced clinical changes in the oral mucosa in users of portion-bag packed oral moist snuff (snus) compared with the changes in the mucosa of loose snus users are correlated to exposure and uptake of tobacco constituents. 54 habitual users of smokeless tobacco were selected for the study: 22 loose snus users, 23 users of portion-bag packed snus and 9 users of chewing tobacco. In accordance with previous findings, less pronounced clinical changes in the oral mucosa were recorded in portion-bag users compared with loose snus users. The clinical findings observed in the oral mucosa of users of chewing tobacco were leukoedema and slight clinical "snus changes". The average intake of nicotine (measured as nicotine equivalents excreted during 24 h) for snus users was 35 mg, and was 50% higher for users of chewing tobacco. The average steady-state saliva cotinine concentration was about 300 ng/ml for both categories of snus users, which is similar to that found in smokers, while the average concentration found in users of chewing tobacco was 50% higher. There was a good correlation between saliva cotinine concentration and the 24 h intake of nicotine. The average excretion profile of nicotine was similar in all three groups of smokeless tobacco users, being on average: nicotine 8%, nicotine-GlcA 3%, cotinine 8%, cotinine-GlcA 9%, 3'-hydroxycotinine 42%, 3'hydroxycotinine-GlcA 19%, nicotine-N'-oxide 9% and cotinine-N-oxide 3%.(ABSTRACT TRUNCATED AT 250 WORDS)
Kabir, M A; Goh, Kim-Leng; Khan, M M H
Adolescent tobacco use (ATU) is on the rise worldwide and the problem is particularly severe in developing countries. Based on nationally representative data, this study aims to investigate the association between ATU and its possible correlates for Bangladesh, where the prevalence rate of ATU is high. The data set is extracted from the Global Youth Tobacco Survey for Bangladesh conducted in 2007. The survey collected information from a total of 3113 students from 52 schools, with a response rate of 100% at the school level, while a response rate of 88.9% was achieved from the students. Students covered in the survey were in grades 7, 8, 9, and 10, with age ranging from 11 to 17 years. The prevalence rate of ATU at the time of the survey was 8.4%, while 35.6% of the students had used at least a type of tobacco products before. Logistic regressions were used to obtain the odds ratios (ORs) in favor of ATU for each of the possible determinants and the confidence intervals (CIs) of these ratios. Use of tobacco among friends (OR = 3.46; CI = 2.37-5.05), the experience of seeing others smoking at home (OR = 2.10; CI = 1.36-3.22) or other places (OR = 1.6; CI = 1.02-2.57), receiving pocket money (OR = 7.6; CI = 4.59-13.28), receiving free tobacco from vendors (OR = 2.3; CI = 1.44-3.78), and exposure to advertisements and promotions of tobacco products (OR = 1.83; CI = 1.23-2.79) were associated with a higher likelihood of ATU. Increased awareness of health hazards of tobacco use through education in schools helped mitigate the problem of ATU. The findings of this study have ramifications for tobacco control prevention strategies in Bangladesh.
Chandirasekar, R; Suresh, K; Sasikala, K; Kumar, B Lakshman; Venkatesan, R; Ganesh, G Karthik; Jacob, Raichel
India has a long history of tobacco, which includes chewing tobacco and smoking tobacco in various forms. Initially, the smokeless tobacco chewing habit was seen among the majority of the farmers who cultivated tobacco; but in recent years, smokeless tobacco is available in many forms and is cheaper as well and hence it is widely being used among literate and illiterate people. The subjects of our study are living in hilly regions of Yerkaud in Salem district, South India. Most of the inhabitants of our study area are illiterate and more particularly they are unaware of the health effects due to tobacco use. Recent epidemiological reports have strongly indicated the association of cancer risk with usage of smokeless tobacco. The prime aim of our study is to evaluate the genotoxic effects of tobacco use by analysing the cytogenetic end points such as chromosome aberrations in peripheral blood and micronucleus in peripheral blood and buccal cells. About 85 smokeless tobacco users were enrolled for the study and same numbers of age- and sex-matched nontobacco users were also enrolled to serve as controls. The result of our study revealed that tobacco users displayed varied levels of elevated chromosomal damage and micronucleated cells than nontobacco users. The variation in the extent of genetic damage was dependent on the duration of the tobacco use. In conclusion, this study might be helpful in creating awareness on the hazards of the smokeless tobacco products among the global population as a whole for those who chose such products as a cheap alternative to tobacco smoke.
Ditchburn, K. Marie; Sellman, J. Douglas
Three main aims of this study were to ascertain the prevalence rate of smoking among adolescent psychiatric outpatients; estimate smokers' degree of nicotine dependence; and investigate the relationship between smoking and common mental health disorders. Face-to-face interviews were conducted on 93 patients ages 13-18 presenting to an adolescent…
Introduction: To examine the extent to which cigarette smoking in adolescence is associated with maladaptive versus adaptive coping behaviors in adulthood. Method: The data came from a longitudinal study of New Zealand adolescents followed into adulthood at age 32 years. Using structural equation modeling (SEM), we examined the predictive association between daily smoking of cigarettes and symptoms of tobacco dependence from 18 to 26 years of age and later coping at age 32 years. We included pathways from childhood family disadvantage in addition to both adolescent stress–worry and adult coping in the model. Results: SEM revealed that cigarette smoking had a small but direct inverse effect on later adaptive coping (−.14) and a direct effect on maladaptive coping (.23) independent of the relationships between adolescent coping and stress–worry and later adult coping. Conclusions: The findings are consistent with the hypothesis that tobacco smoking may inhibit the development of self-efficacy or one’s ability to act with appropriate coping behaviors in any given situation. PMID:23817581
Alaska Native smokers and smokeless tobacco users with slower CYP2A6 activity have lower tobacco consumption, lower tobacco-specific nitrosamine exposure and lower tobacco-specific nitrosamine bioactivation.
Zhu, Andy Z X; Binnington, Matthew J; Renner, Caroline C; Lanier, Anne P; Hatsukami, Dorothy K; Stepanov, Irina; Watson, Clifford H; Sosnoff, Connie S; Benowitz, Neal L; Tyndale, Rachel F
Nicotine, the psychoactive ingredient in tobacco, is metabolically inactivated by CYP2A6 to cotinine. CYP2A6 also activates procarcinogenic tobacco-specific nitrosamines (TSNA). Genetic variation in CYP2A6 is known to alter smoking quantity and lung cancer risk in heavy smokers. Our objective was to investigate how CYP2A6 activity influences tobacco consumption and procarcinogen levels in light smokers and smokeless tobacco users. Cigarette smokers (n = 141), commercial smokeless tobacco users (n = 73) and iqmik users (n = 20) were recruited in a cross-sectional study of Alaska Native people. The participants' CYP2A6 activity was measured by both endophenotype and genotype, and their tobacco and procarcinogen exposure biomarker levels were also measured. Smokers, smokeless tobacco users and iqmik users with lower CYP2A6 activity had lower urinary total nicotine equivalents (TNE) and (methylnitrosamino)-1-(3)pyridyl-1-butanol (NNAL) levels (a biomarker of TSNA exposure). Levels of N-nitrosonornicotine (NNN), a TSNA metabolically bioactivated by CYP2A6, were higher in smokers with lower CYP2A6 activities. Light smokers and smokeless tobacco users with lower CYP2A6 activity reduce their tobacco consumption in ways (e.g. inhaling less deeply) that are not reflected by self-report indicators. Tobacco users with lower CYP2A6 activity are exposed to lower procarcinogen levels (lower NNAL levels) and have lower procarcinogen bioactivation (as indicated by the higher urinary NNN levels suggesting reduced clearance), which is consistent with a lower risk of developing smoking-related cancers. This study demonstrates the importance of CYP2A6 in the regulation of tobacco consumption behaviors, procarcinogen exposure and metabolism in both light smokers and smokeless tobacco users.
Bosson, Marlene; Maggiori, Christian; Gygax, Pascal Mark; Gay, Christelle
The present study constitutes an investigation of tobacco consumption, related attitudes and individual differences in smoking or non-smoking behaviors in a sample of adolescents of different ages in the French-speaking part of Switzerland. We investigated three school-age groups (7th-grade, 9th-grade, and the second-year of high school) for…
White, James; Halliwell, Emma
This longitudinal study tested the direction of associations between family meals and alcohol and tobacco consumption during early adolescence. We examined family meal frequency, family connectedness, alcohol (binge drinking, drunkenness), and tobacco consumption (past year, daily frequency) in 671 adolescents (51% women; mean age, Wave 1 = 14.05…
West, Joshua H.; Blumberg, Elaine J.; Kelley, Norma J.; Hill, Linda; Sipan, Carol L.; Schmitz, Katherine E.; Kolody, Bohdan; Chambers, Christina D.; Friedman, Lawrence S.; Hovell, Melbourne F.
Parents can impact adolescent substance use, but it is unclear which substances are most affected. This study compared associations between parenting behaviors and alcohol and tobacco use to see if parenting was equally related to both behaviors. Alcohol and tobacco use data were collected from 252 Latino adolescents living along the San…
Meyer, Michael G.; Toborg, Mary A.; Denham, Sharon A.; Mande, Mary J.
Context: Appalachia has high rates of tobacco use and related health problems, and despite significant impediments to alcohol use, alcohol abuse is common. Adolescents are exposed to sophisticated tobacco and alcohol advertising. Prevention messages, therefore, should reflect research concerning culturally influenced attitudes toward tobacco and…
Pattanshetty, S; Kotrashetti, V S; Nayak, R; Bhat, K; Somannavar, P; Babji, D
There is increasing evidence of a causal association between human papillomavirus (HPV) and oral squamous cell carcinoma (OSCC). Several studies have shown that HPV is associated with increased risk of oral cancer independent of exposure to tobacco and alcohol. The association is valid for HPVs 16 and 18, which generally are considered high risk types, because they have been detected in oral dysplastic lesions and cancers. We determined the baseline prevalence of HPVs 16 and 18 in normal oral mucosa of individuals with and without tobacco habit. PCR was used for DNA collected by oral smears to detect HPV 16/18 DNA in normal oral mucosa of 60 healthy individuals who were assigned to two groups of 30 subjects each. One group had a tobacco habit, the other did not. The tobacco user group comprised individuals who were tobacco chewers only. Sixty-five percent of individuals were positive for HPV 16/18 DNA, but HPV 16/18 positivity was less in individuals with tobacco habit than in those without tobacco habit. No significant association was found between the presence of HPVs and gender, age or duration of chewing habit, or between groups with and without a tobacco habit. We propose that HPVs16 and 18 commonly are present in normal oral mucosa and emphasize the importance of distinguishing clinical, subclinical and latent HPV infections when investigating HPVs and OSCC.
Pollard, Michael S; Tucker, Joan S; Green, Harold D; Kennedy, David; Go, Myong-Hyun
This article examines how friendship networks in adolescence are linked to tobacco use trajectories through a combination of analytic techniques that traditionally are located in separate literatures: social network analysis and developmental trajectory analysis. Using six years of longitudinal data from the National Longitudinal Study of Adolescent Health, we identify a set of six unique developmental trajectories of smoking (never smokers, steady lows, delayed increasers, early increasers, decreasers, and steady highs). Individuals' locations in their friendship networks were then linked to their trajectory group membership. Adolescents with a greater number of smoking friends were more likely to belong to the higher use trajectories. Beyond this exposure to smoking peers, individuals who at baseline were either members of a smoking group or liaisons to a smoking group were more likely than members of a nonsmoking group to belong to the higher use trajectories. Liaisons to a smoking group were particularly likely to belong to the delayed increaser trajectory group. Trajectory group membership for adolescents who belonged to a nonsmoking group did not significantly differ from those who were isolates or liaisons to a nonsmoking group. The study suggests features of an individual's social network have long-lasting associations with smoking behaviors.
Mendoza, Ramón; López Pérez, Pilar
This paper aims to describe the prevalence of tobacco consumption among pre-adolescent and adolescent school children in Spain at the start of the 21st century. The data were collected within the framework of the "Estilos de Vida de los Adolescentes Escolarizados" (EVAE) project, a nationwide cross-sectional study on the lifestyles of adolescent school children. In this study, a random sample of 8429 students aged from 10 to 18 years old (49.9% boys and 50.1% girls) was selected. The school children filled in an anonymous questionnaire in their classrooms. Among the 12-year-old age group, there are a significantly higher number of boys than girls who have ever smoked tobacco. Figures are higher for girls in the 14-year-old or older age groups. Between the 12 and the 14-year-old age groups, there is an increase of 40 percentage points for girls who have ever smoked tobacco. The prevalence of daily smoking exceeds 10% among the 14-year-old or older age groups, with significantly higher rates for girls than for boys among the 15-year-old group and older students. Among the 17-year-old group, 25% of boys and 35% of girls report that they smoke daily. The recent experience of Spain and other countries shows that it is possible to significantly reduce the prevalence of tobacco consumption among school children within a few years. The primary prevention of tobacco consumption among adolescents can be highly effective and should constitute a priority for the health system, the education system and other sectors involved.
Chandirasekar, R; Kumar, B Lakshman; Sasikala, K; Jayakumar, R; Suresh, K; Venkatesan, R; Jacob, Raichel; Krishnapriya, E K; Kavitha, H; Ganesh, G Karthik
Inexpensive forms of tobacco are widely used in developing countries such as India. We have evaluated genotoxicity endpoints (chromosome aberrations, micronucleus frequency, comet assay) and polymorphisms of the XRCC1 and p53 genes among smokers and smokeless tobacco (SLT) users in rural Tamilnadu, South India. Cytogenetic, DNA damage and SNP analyses were performed on peripheral blood samples; micronucleus frequency was measured in peripheral blood and buccal mucosa exfoliated cells. Both categories of tobacco users had elevated levels of genotoxic damage. SNP analysis of tobacco users revealed that 17% carry the XRCC1 gln399gln genotype and 19% carry the p53 pro72pro genotype. Both genotypes are associated with increased risk of cancer.
Adlaf, Edward M.; Smart, Reginald G.
Examined rates of steroid use among Ontario adolescent students. Findings from 3,892 students revealed that 1.1 percent reported using steroids over past year. Steroid users were significantly more likely to use stimulants, caffeine, and relaxants than were nonsteroid users. Demographically, steroid users were significantly more likely to be male…
Gray, Jennifer N; Breland, Alison B; Weaver, Michael; Eissenberg, Thomas
Several potential reduced exposure products (PREPs) for smokeless tobacco (SLT) users are marketed in the United States, though their effects are largely unknown. These products include some that are low in tobacco-specific nitrosamines (TSNs), like Stonewall, a pressed tobacco tablet, and General snus, a moist snuff product produced in Sweden. Methodology assessing the toxicant exposure and effects of cigarette-like PREPs for smokers has been developed, and might be modified for use in evaluating PREPs for SLT users. This report describes two studies examining the toxicant exposure and effects of two PREPs for SLT users. Study 1 (n = 13) consisted of four 4.5-hr laboratory sessions where SLT products (own brand, Stonewall, General snus, and tobacco-free placebo) were used for four 30-min episodes and nicotine exposure and tobacco/nicotine abstinence symptoms were measured. Study 2 (n = 19) consisted of four 5-day ad libitum use periods when participants used own brand, Stonewall, General snus, or no SLT and urinary levels of metabolites of nicotine (cotinine) and the TSN 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNAL) and abstinence symptoms were measured. Compared with own brand, Stonewall was associated with lower levels of cotinine and NNAL, while General snus was associated with similar levels of cotinine and lower levels of NNAL. Abstinence symptoms generally did not differ across tobacco conditions. These results show that clinical laboratory methods can be used to evaluate the toxicant exposure and abstinence symptom suppression associated with PREPs for SLT users.
Williams, Valerie; Rath, Jessica; Villanti, Andrea C.; Vallone, Donna
Objectives. We monitored the prevalence and patterns of use of the array of tobacco products available to young adults, who are at risk for initiation and progression to established tobacco use. Methods. We used data from waves 1 to 3 of GfK’s KnowledgePanel (2011–2012), a nationally representative cohort of young adults aged 18 to 34 years (n = 2144). We examined prevalence and patterns of tobacco product use over time, associated demographics, and state-level tobacco policy. We used multivariable logistic regression to determine predictors of initiation of cigarettes as well as noncombustible and other combustible products. Results. The prevalence of ever tobacco use rose from 57.28% at wave 1 to 67.43% at wave 3. Use of multiple products was the most common pattern (66.39% of tobacco users by wave 3). Predictors of initiation differed by product type and included age, race/ethnicity, policy, and use of other tobacco products. Conclusions. Tobacco use is high among young adults and many are using multiple products. Efforts to implement policy and educate young adults about the risks associated with new and emerging products are critical to prevent increased initiation of tobacco use. PMID:24922152
Geetha, Seema; Thomas, Gigi; Sebastian, Paul
Objectives. Limited information is available on adolescent tobacco and alcohol use in rural Kerala, the southernmost state in India. The study was conducted to estimate the prevalence of tobacco and alcohol use among adolescent school students and further to understand the extent of knowledge pertaining to tobacco before and after conducting awareness programmes in schools. Methods. A cross-sectional study was conducted in 10 government schools of rural Thiruvananthapuram district of Kerala state based on a multistaged sampling design. Using a pretested semistructured questionnaire, prevalence and patterns of tobacco use by students and their households, as well as students' knowledge on tobacco hazards before and after delivering antitobacco messages, were collected. Results. The overall prevalence of self-reported ever users of tobacco in the current academic year was 7.4% (95% CI 5.86–8.94), while that of ever alcohol users was 5.6% (95% CI 4.25–6.95). Knowledge assessment scores revealed a significant increase in the mean knowledge scores after posttraining evaluation (mean score = 10.34) when compared to pretraining evaluation (mean score = 9.26) (p < 0.0001). Conclusion. Apart from antitobacco awareness programmes, strict monitoring of trade of tobacco and alcohol products near educational institutions has to be conducted consistently to curb the problem. PMID:27630784
Hatsukami, Dorothy; And Others
Examined the effects of 2 mg of nicotine polacrilex versus placebo gum and a group behavioral treatment versus minimal contact on cessation of smokeless tobacco use. Participants (n=210) were randomly assigned 1 of the 4 treatment conditions. Withdrawal symptoms were assessed throughout the treatment. Discusses findings. (KW)
Burnett, Kent F.; Kleiman, Mark E.
Used Millon Adolescent Personality Inventory and Profile of Mood States to assess psychological characteristics in 72 adolescent males: 24 adolescent athletes who reported steroid use, 24 athletes with no steroid use, and 24 nonathletes. Although some personality variables differentiated between athletes and nonathletes, no personality variables…
Fuqua, Juliana L.; Gallaher, Peggy E.; Unger, Jennifer B.; Trinidad, Dennis R.; Sussman, Steve; Ortega, Enrique; Johnson, C. Anderson
Associations between peer group self-identification and smoking were examined among 2,698 ethnically diverse middle school students in Los Angeles who self-identified with groups such as Rockers, Skaters, and Gamers. The sample was 47.1% male, 54.7% Latino, 25.4% Asian, 10.8% White, 9.1% Other ethnicity, and 59.3% children of immigrant parents. Multiple group self-identification was common: 84% identified with two or more groups and 65% identified with three or more groups. Logistic regression analyses indicated that as students endorsed more high-risk groups, the greater their risk of tobacco use. A classification tree analysis identified risk groups based on interactions among ethnicity, gender, and group self-identification. Psychographic targeting based on group self-identification could be useful to design more relevant smoking prevention messages for adolescents who identify with high-risk peer groups. PMID:22458850
El Awa, F; Fouad, H; El Naga, R A; Emam, A H; Labib, S
Egypt assessed tobacco use among young people and adults through implementation in 2009 of the Global Youth Tobacco Survey (GYTS) among school students aged 13-15 years and the nationally representative Global Adult Tobacco Survey (GATS) among adults aged 15+ years. Both surveys employed cluster sampling to produce nationally representative samples and used standard core questionnaires with optional, country-specific questions. The results indicated that a higher percentage of adolescent girls in Egypt used tobacco than did adult females. Overall, 3.8% of girls aged 13-15 years used some form of tobacco compared with 0.6% of women aged 15+ years. Adolescents were over 14 times more likely than adult women to currently smoke cigarettes and 11 times more likely to smoke waterpipes. Moreover, the prevalence of cigarette smoking among adolescent girls had increased from 1.4% in the 2005 GYTS to 2.8% in 2009, indicating that social and cultural norms may be changing.
Sutfin, Erin L; Szykman, Lisa R; Moore, Marian Chapman
Anti-smoking media directed at adolescents use many different message themes, but little evidence exists as to which is most effective. Additionally, little is known about how teens who smoke respond to anti-tobacco ads. This study examined smoking and nonsmoking adolescents' responses to three popular thematic approaches: (1) endangering others, (2) negative life circumstances, and (3) industry manipulation. Sixteen groups of high school students (total N=488) were randomly assigned in a balanced fashion to one of three anti-tobacco ad conditions or a control condition. Outcome variables included adolescents' immediate emotional and cognitive responses, and intentions to smoke. Adolescents exposed to negative life circumstances ads reported lower intentions to smoke than those exposed to control and industry manipulation ads. Additionally, adolescents' responses differed based on smoking status. Smokers liked the ads less and had fewer positive and more negative thoughts. Findings suggest a media campaign focusing on negative life circumstances can be an effective component of a tobacco control program aimed at adolescents. Mechanisms through which the negative life circumstances ads influence adolescents' intentions to smoke are discussed. Findings also suggest that smokers respond differently to anti-tobacco ads, and their responses need to be considered when developing effective anti-tobacco advertising campaigns.
Huque, Rumana; Shah, Sarwat; Mushtaq, Nasir; Siddiqi, Kamran
Introduction More than 80% of all smokeless tobacco (ST) products in the world are consumed in South Asia; yet little is known about their consumption behaviour, addictiveness, and toxic properties. This paper, for the first time, describes associations between salivary cotinine concentrations among ST users in Bangladesh and their socio-demographic characteristics and tobacco use behaviours. Methods In a survey of ST users in Dhaka, Bangladesh, we purposively recruited 200 adults who were non-smokers but consumed ST on a regular basis. In-person interviews were conducted to obtain information about socio-demographic and ST use behaviours, and saliva samples were collected to measure cotinine concentration. Simple and multiple linear regression analyses were conducted to test associations between the log transformed salivary cotinine concentration and other study variables. Results The geometric mean of cotinine concentration among ST users was 380ng/ml (GSD:2). Total duration of daily ST use in months had a statistically significant association with cotinine concentration. Other ST use characteristics including type and quantity of ST use, swallowing of tobacco juice, urges and strength of urges and attempts to cut down on tobacco use were not found to be associated with cotinine concentration in a multivariable model. Conclusion This is the first report from Bangladesh studying cotinine concentration among ST users and it points towards high levels of addiction. This warrants effective tobacco control policies to help ST cessation and prevention. PMID:27504912
Mason, Michael J.; Mennis, Jeremy; Schmidt, Christopher D.
This study tested a mediation model of the relationship with tobacco use, social network quality (level of risk or protection in a network), and substance use (alcohol and/or illicit drugs) with a sample of 301 urban adolescents. It was theorized that social network quality would mediate the effect of tobacco use, accounting for PTSD symptoms and…
Singh, Nisha; Krishnan-Sarin, Suchitra
Aim: Emerging racial/ethnic disparities in tobacco use behaviors and resulting long-term health outcomes highlight the importance of developing culturally tailored/targeted tobacco prevention and cessation interventions. This manuscript describes the efficacy and the components of prevention and cessation interventions developed for minority adolescents. Methods: Thirteen studies focused on culturally tailoring and targeting tobacco prevention/cessation interventions were selected and information on intervention design (type, number of sessions), setting (school or community), theoretical constructs, culture-specific components (surface/deep structures), and treatment outcomes were extracted. Results: Of the 13 studies, 5 focused on prevention, 4 on cessation, and 4 combined prevention and cessation, and most of the studies were primarily school-based, while a few used community locations. Although diverse minority groups were targeted, a majority of the studies (n = 6) worked with Hispanic adolescents. The most common theoretical construct examined was the Social Influence Model (n = 5). The overall findings indicated that culturally tailoring cessation interventions did not appear to improve tobacco quit rates among minority adolescents, but culturally tailored prevention interventions appeared to produce lower tobacco initiation rates among minority adolescents than control conditions. Conclusions: The results of review suggest that there is a critical need to develop better interventions to reduce tobacco use among minority adolescents and that developing a better understanding of cultural issues related to both cessation and initiation of tobacco use among minority populations is a key component of this endeavor. PMID:22614548
Katuri, Kishore Kumar; Chintagunta, Chaitanya; Tadiboina, Nagarjuna; Borugadda, Ravithej; Loya, Mitali; Marella, Yamuna; Bollepalli, Appaiah Chowdary
Introduction Oral smokeless tobacco consumption has been considered as a major risk factor for oral cancer, its role as a risk factor for periodontal disease is less well documented when compared to that of relationship between smoking and periodontal disease. Aim The aim of the present cross-sectional study was to evaluate the effect of various forms of tobacco consumption i.e., smoking and smokeless tobacco forms on periodontal status. Materials and Methods The study population included 120 subjects with the habit of tobacco consumption, based on form of tobacco use they were divided into Group 1 (smoking), Group 2 (Smokeless tobacco), and Group 3 (smokers and smokeless tobacco users). The periodontal status for each group was evaluated by measuring Oral Hygiene Index- Simplified (OHI-S) and Community Periodontal Index (CPI) for Probing Depth (CPI-PD) and Attachment Loss (CPI-AL). Results OHI-S mean scores in Group 1 (3.53±1.03), Group 2 (3.06±0.92) and Group 3 (3.45±0.96) were similar, which were not statistically significant (p>0.076). The mean values of CPI-PD were 3.75±0.44 in Group 1, 3.65±0.48 in Group 2, 3.80±0.41 in Group 3 with no significant difference between the three Groups (p> 0.309). When the mean values of CPI-AL (0.95±0.75 in Group 1, 1.40±0.74 in group 2, and 1.55±0.60 in Group 3) were compared in between the Groups, a statistically significant difference was observed in Group 3 (p<0.001). Conclusion The results showed that tobacco consumption in both forms caused poor periodontal status, with smokeless tobacco users having more amount of attachment loss than smokers. PMID:27891477
Kostygina, Ganna; Glantz, Stanton A.; Ling, Pamela M.
Objective While flavoured cigarettes were prohibited in the US in 2009, flavoured little cigars and cigarillos (LCCs) remain on the market. We describe the evolving strategies used by tobacco companies to encourage uptake of flavoured little cigars and cigarillos and industry research findings on consumer perceptions of flavoured LCC products. Methods Analysis of internal tobacco industry documents was triangulated with data from tobacco advertisement archives, national newspapers, trade press, and the Internet. Results Flavoured little cigar and cigarillo products were associated with young and inexperienced tobacco users, women and African Americans. Internal industry studies confirmed that menthol and candy-like flavours (e.g., vanilla, cherry) increased LCC appeal to starters by masking the heavy cigar taste, reducing throat irritation, and making LCC smoke easier to inhale. To appeal to new users, manufacturers also reduced the size of cigars to make them more cigarette-like, introduced filters and flavoured filter tips, emphasized mildness and ease of draw in advertising, and featured actors using little cigars in television commercials. RJ Reynolds tried to capitalize on the popularity of menthol cigarettes among African Americans and marketed a menthol little cigar to African Americans. Conclusions Tobacco companies engaged in a calculated effort to blur the line between little cigars and cigarettes to increase appeal to cigarette smokers, and the use of flavours facilitated these efforts. Bans on flavoured cigarettes should be expanded to include flavoured LCCs, and tobacco use prevention initiatives should include LCCs. PMID:25354674
Soneji, Samir; Ambrose, Bridget K.; Lee, Won; Sargent, James; Tanski, Susanne
Objective We assess exposure to direct-to-consumer tobacco marketing and its association with ever having tried smoking, smoking within past 30 days (‘current’), and smoking ≥100 cigarettes in lifetime (‘established’) among adolescents and young adults. Methods We surveyed a U.S. telephone sample of 3,342 15–23 year olds and 2,541 respondents subsequently completed a web-based survey. Among respondents completing both the telephone and web-based surveys (N=2,541 [75%]), we assessed their exposure to direct-to-consumer tobacco marketing (receiving direct mail from tobacco companies and seeing tobacco company websites) and their associations with ever having tried smoking, current smoking, and established smoking. Results Overall, 12% of 15–17 year olds and 26% of 18–23 year olds were exposed to direct-to-consumer tobacco marketing. Racial/ethnic minority non-smoking respondents were more likely to see tobacco websites than non-smoking Whites. Respondents exposed to either form of direct-to-consumer tobacco marketing were more likely to currently smoke (adjusted odds ratio[AOR]: 2.2; 95% CI 1.3–3.8), while those exposed to both forms of marketing experienced even higher odds of currently smoking (AOR: 2.7; 95% CI 1.1–6.6). We observed similar relationships for ever having tried smoking and established smoking. Conclusions Direct-to-consumer tobacco marketing reaches adolescent and young adult non-smokers and is associated with smoking behavior. PMID:24661738
Singh, Pramil N; Neergaard, Jim; Job, Jayakaran S; El Setouhy, Maged; Israel, Ebenezer; Mohammed, Mostafa K; Loffredo, Christopher A
Waterpipe use is a highly prevalent form of tobacco use in the Eastern Mediterranean Region that is rooted in long-held cultural traditions that predate the use of cigarettes and present a particular challenge for tobacco control efforts. We did a stratified sampling of 4,994 Egyptian men from rural households of Egypt in order to conduct an interviewer-administered prevalence survey to identify differences in attitudes and beliefs toward smoking and smoking cessation between waterpipe users, cigarette smokers, mixed users (cigarette + waterpipe), and non-smokers. We found that cigarette smokers, mixed users, and/or non-smokers were (1) two- to ninefold more likely to believe that smoking decreased adult life expectancy and harmed a fetus than waterpipe users, (2) significantly more likely to believe that smoking is a sin ("haram") than were waterpipe users. Among tobacco users, we found that cigarette smokers and/or mixed users were significantly more likely to indicate pre-contemplation, contemplation, or intention to quit tobacco than waterpipe users. Our findings from rural Egyptian men indicate that waterpipe users are distinct from cigarette smokers in their perception that their form of tobacco use is less harmful and/or less subject to religious proscription. These beliefs may explain why waterpipe users seem less inclined to quit their tobacco habit and need to be considered in the design of tobacco cessation and prevention methods in Egypt and the region.
Neergaard, Jim; Job, Jayakaran S.; El Setouhy, Maged; Israel, Ebenezer; Mohammed, Mostafa K.; Loffredo, Christopher A.
Waterpipe use is a highly prevalent form of tobacco use in the Eastern Mediterranean Region that is rooted in long-held cultural traditions that predate the use of cigarettes and present a particular challenge for tobacco control efforts. We did a stratified sampling of 4,994 Egyptian men from rural households of Egypt in order to conduct an interviewer-administered prevalence survey to identify differences in attitudes and beliefs toward smoking and smoking cessation between waterpipe users, cigarette smokers, mixed users (cigarette + waterpipe), and non-smokers. We found that cigarette smokers, mixed users, and/or non-smokers were (1) two- to ninefold more likely to believe that smoking decreased adult life expectancy and harmed a fetus than waterpipe users, (2) significantly more likely to believe that smoking is a sin (“haram”) than were waterpipe users. Among tobacco users, we found that cigarette smokers and/or mixed users were significantly more likely to indicate pre-contemplation, contemplation, or intention to quit tobacco than waterpipe users. Our findings from rural Egyptian men indicate that waterpipe users are distinct from cigarette smokers in their perception that their form of tobacco use is less harmful and/or less subject to religious proscription. These beliefs may explain why waterpipe users seem less inclined to quit their tobacco habit and need to be considered in the design of tobacco cessation and prevention methods in Egypt and the region. PMID:21125424
Knight, Rebecca; Williams, Rebecca J.; Pagano, Ian; Sargent, James D.
OBJECTIVE: To describe electronic cigarette (e-cigarette) use and cigarette use among adolescents and determine whether established risk factors for smoking discriminate user categories. METHODS: School-based survey of 1941 high school students (mean age 14.6 years) in Hawaii; data collected in 2013. The survey assessed e-cigarette use and cigarette use, alcohol and marijuana use, and psychosocial risk and protective variables (eg, parental support, academic involvement, smoking expectancies, peer smoking, sensation seeking). Analysis of variance and multinomial regression examined variation in risk and protective variables across the following categories of ever-use: e-cigarette only, cigarette only, dual use (use of both products), and nonuser (never used either product). RESULTS: Prevalence for the categories was 17% (e-cigarettes only), 12% (dual use), 3% (cigarettes only), and 68% (nonusers). Dual users and cigarette-only users were highest on risk status (elevated on risk factors and lower on protective factors) compared with other groups. E-cigarette only users were higher on risk status than nonusers but lower than dual users. E-cigarette only users and dual users more often perceived e-cigarettes as healthier than cigarettes compared with nonusers. CONCLUSIONS: This study reports a US adolescent sample with one of the largest prevalence rates of e-cigarette only use in the existing literature. Dual use also had a substantial prevalence. The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use. PMID:25511118
Martens, K M; Gilbert, David G
In order to better compare affect-related expectancies for tobacco and marijuana smoking, associations of marijuana and tobacco exposure to negative affect reduction (NAR), positive affect enhancement (PAE), and related smoking outcome expectancies were assessed in young individuals who reported smoking both marijuana and tobacco on a regular basis (dual users). More frequent smoking of a given substance was associated with expectations of greater NAR and PAE by that substance while duration of exposure did not reliably predict NAR or PAE drug expectancies. Contrary to expectations, individuals anticipating greater NAR and/or PAE for one substance did not exhibit corresponding expectancies for the other drug. These findings suggest that exposure duration may be less important than current usage levels in influencing affect expectancies and that the affect-related expectancies for tobacco and marijuana are largely independent of each other.
Smith, Matthew Lee; Barry, Adam E; Merianos, Ashley L
Alcohol, tobacco, and marijuana are commonly used substances among adolescents. In the context of the Biopsychosocial Model (BPSM), this study investigated the relationships between psychological and normative factors associated with adolescent alcohol, tobacco, and marijuana use. Data were analyzed from 1053 middle and high school students. Structural equation modeling was used to examine the relationships between BPSM constructs. Results indicate that latent constructs of the BPSM are significant antecedent factors to alcohol, tobacco, and marijuana use; however, the relationships between study constructs were inconsistent with those theorized by BPSM. Findings support the importance of theory testing for complex models applied to new topics and new populations.
Farhad Mollashahi, Leila; Honarmand, Marieh; Nakhaee, Alireza; Mollashahi, Ghasem
Background Smokeless tobacco chewing is one of the known risk factors for oral cancer. It is consumed widely by residents of southeastern Iran. Objectives In this study, salivary free and total sialic acid, and total protein were compared in paan consumers and non-consumers. Patients and Methods In this cross-sectional study, unstimulated saliva of 94 subjects (44 paan consumers and 50 non-consumers) who were referred to the oral medicine department of the dentistry school of Zahedan were collected. Salivary free and total sialic acid, and total protein concentration were measured by standard biochemical methods, and the obtained data were analyzed using SPSS 20 through the non-parametric Mann-Whitney test. Results The concentration of salivary free sialic acid (23.21 ± 18.98 mg/L) was significantly increased in paan consumers. The concentration of salivary Total sialic acid (TSA) (39.57 ± 26.58 mg/L) and total protein (0.77 ± 0.81 mg/mL) showed increases in paan consumers, however, the results were not statistically significant. Conclusions Salivary free and total sialic acid, and total protein were higher in the paan consumers compared to non-consumers. Due to the carcinogenic effect of smokeless tobacco, measurement of these parameters in saliva may be useful in early detection of oral cancer. PMID:27622172
Al-Attas, Safia Ali; Ibrahim, Suzan Seif; Amer, Hala Abbas; Darwish, Zeinab El-Said; Hassan, Mona Hassan
Smoking is recognized as a health problem worldwide and there is an established tobacco epidemic in Saudi Arabia as in many other countries, with tobacco users at increased risk of developing many diseases. This cross sectional study was conducted to assess the prevalence of oral mucosal, potentially malignant or malignant, lesions associated with tobacco use among a stratified cluster sample of adults in Jeddah, Saudi Arabia. A sample size of 599 was collected and each participant underwent clinical conventional oral examination and filled a questionnaire providing information on demographics, tobacco use and other relevant habits. The most common form of tobacco used was cigarette smoking (65.6 %) followed by Shisha or Moasel (38.1%), while chewing tobacco, betel nuts and gat accounted for 21-2%, 7.7%, and 5% respectively. A high prevalence (88.8%) of soft tissue lesions was found among the tobacco users examined, and a wide range of lesions were detected, about 50% having hairy tongue, 36% smoker's melanosis, 28.9% stomatitis nicotina, 27% frictional keratosis, 26.7% fissured tongue, 26% gingival or periodontal inflammation and finally 20% leukodema. Suspicious potentially malignant lesions affected 10.5% of the subjects, most prevalent being keratosis (6.3%), leukoplakia (2.3%), erythroplakia (0.7%), oral submucous fibrosis (0.5%) and lichenoid lesions (0.4%), these being associated with male gender, lower level of education, presence of diabetes and a chewing tobacco habit. It is concluded that smoking was associated with a wide range of oral mucosal lesions , those suspicious for malignancy being linked with chewable forms, indicating serious effects.
Cai, Yong; Lu, Lin; Li, Na; Zhu, Jingfen; He, Yaping; Redmon, Pamela; Goyal, Abhinav; Huang, Cheng; Qiao, Yun; Ma, Jin
Objective: To estimate the prevalence and social, psychological and environmental-structural determinants of tobacco experimentation among adolescents in Shanghai, China. Methods: We conducted a cross-sectional study based on a two-stage cluster sample design by using the Chinese version of the Global Youth Tobacco Survey (GYTS) to investigate smoking behavior among 19,117 students from 41 junior and senior high schools in Shanghai, China. The association between potential factors and tobacco experimentation were assessed using complex samples procedure logistic regression. Results: Of the 19,117 respondents, 10.5% (15.3% boys and 6.2% girls) reported the tobacco experimentation. The main social, psychological, and environmental-structural factors associated with tobacco experimentation were having close friends who smoke (AOR = 8.21; 95% CI: 6.49–10.39); one or both parents smoking (AOR 1.57; CI: 1.39–1.77); a poor school tobacco control environment (AOR 1.53; CI: 1.37–1.83); a high acceptance level of tobacco use (AOR 1.44; CI: 1.28–1.82); and a high level of media tobacco exposure (AOR 1.23; CI: 1.10–1.37). Peer smoking might contribute to smoking experimentation among girls (AOR 8.93; CI: 5.84–13.66) more so than among boys (AOR 7.79; CI: 5.97–9.94) and media tobacco exposure had no association with tobacco experimentation among female students. Conclusions: Social, psychological, and environmental factors are closely associated with tobacco experimentation among adolescents. Prevention programs aimed at reducing teen tobacco experimentation should be conducted at home and school with support by parents, peers and teachers. Our findings should prove useful for future development of intervention strategies among adolescents in Shanghai, China. PMID:23202754
Gupta, P. C.; Mehta, H. C.
INTRODUCTION: Overall mortality rates are higher among cigarette smokers than non-smokers. However, very little is known about the health effects of other forms of tobacco use widely prevalent in India, such as bidi smoking and various forms of smokeless tobacco (e.g. chewing betel-quid). We therefore carried out a cohort study in the city of Mumbai, India, to estimate the relative risks for all-cause mortality among various kinds of tobacco users. METHODS: A baseline survey of all individuals aged > or = 35 years using voters' lists as a selection frame was conducted using a house-to-house approach and face-to-face interviews. RESULTS: Active follow-up of 52,568 individuals in the cohort was undertaken 5-6 years after the baseline study, and 97.6% were traced. A total of 4358 deaths were recorded among these individuals. The annual age-adjusted mortality rates were 18.4 per 1000 for men and 12.4 per 1000 for women. For men the mortality rates for smokers were higher than those of non-users of tobacco across all age groups, with the difference being greater for lower age groups (35-54 years). The relative risk was 1.39 for cigarette smokers and 1.78 for bidi smokers, with an apparent dose-response relationship for frequency of smoking. Women were basically smokeless tobacco users, with the relative risk among such users being 1.35 and a suggestion of a dose-response relationship. DISCUSSION: These findings establish bidi smoking as no less hazardous than cigarette smoking and indicate that smokeless tobacco use may also cause higher mortality. Further studies should be carried out to obtain cause-specific mortality rates and relative risks. PMID:10994260
Georgiades, Katholiki; Boyle, Michael H.
Background: This study examines the longitudinal associations between adolescent tobacco and cannabis use and young adult functioning. Methods: Data for analysis come from the Ontario Child Health Study (OCHS), a prospective study of child health, psychiatric disorder and adolescent substance use in a general population sample that began in 1983,…
Zullig, Keith J.; Teoli, Dac A.; Valois, Robert F.
This study examined relationships between emotional self-efficacy (ESE) and alcohol and tobacco use in a statewide sample of public high school adolescents (n?=?2,566). The Center for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression analyses indicated the presence of any significant race by…
Martinasek, Mary P.; Gibson-Young, Linda; Forrest, Jamie
Background: Hookah tobacco smoking has increased in prevalence among Florida adolescents and is often viewed as a safer alternative to cigarette smoking by young adults. Asthmatic adolescents are at increased risk of the negative health effects of hookah smoking. The purpose of this study is to examine if hookah use and harm perception vary by…
Escota, Gerome; Önen, Nur
Tobacco use is inextricably linked to a number of health risks both in the general and HIV-infected populations. There is, however, a dearth of research on effective tobacco control programs among people living with HIV, and especially among adolescents, young adults and pregnant women, groups with heightened or increased vulnerability secondary to tobacco use. Adolescents and young adults constitute a growing population of persons living with HIV infection. Early and continued tobacco use in this population living with a disease characterized by premature onset multimorbidity and chronic inflammation is of concern. Additionally, there is an increased acuity for tobacco control among HIV-infected pregnant women to reduce pregnancy morbidity and improve fetal outcome. This review will provide an important summary of current knowledge of tobacco use among HIV-infected adolescents, young adults and pregnant women. The effects of tobacco use in these specific populations will be presented and the current state of tobacco control within these populations, assessed. PMID:23778059
Kram, Yoseph; Klesges, Robert C.; Talcott, Wayne; Neilands, Torsten B.; Ling, Pamela M.
Introduction: To describe the characteristics associated with patterns of daily and dual tobacco use among U.S. Air Force (USAF) personnel transitioning from basic military training to technical training. Methods: Cross-sectional survey of USAF personnel in Technical Training School at Lackland Air Force Base (N = 8,956, response rate: 73%). Logistic regression analyzed the association of predictor variables between daily smokers, daily smokeless tobacco (ST) users, daily smokers who used ST nondaily, daily ST users who smoked cigarettes nondaily, and daily users of both cigarettes and ST. Results: Compared to daily smokers, participants who were daily smokers/nondaily ST users were more likely to be male, would use ST and multiple forms of tobacco in the future, reported more friends using ST and cigarettes, and were more susceptible to tobacco advertising. Compared to daily ST users, daily ST users/nondaily cigarette users were more likely to live in the Midwest, would use multiple forms of tobacco in the future, reported more friends smoked cigarettes and used ST, and were more likely to try a product that claimed to be safer than cigarettes. Daily users of both cigarettes and ST were significantly more likely to be nicotine dependent than daily smokers/nondaily ST users and daily ST users/nondaily smokers. Conclusions: Dual users are heterogeneous groups of tobacco users who are at high risk for continued tobacco use. Daily users of both cigarettes and ST have higher levels of nicotine dependence, even when compared to other dual users. Specific interventions targeted at dual users are needed in this increasingly prevalent and high-risk population. PMID:24721813
Rass, Olga; Pacek, Lauren R; Johnson, Patrick S; Johnson, Matthew W
Awareness and use of electronic cigarettes (e-cigarettes) is increasing. Questions regarding positive (e.g., smoking reduction/cessation) and negative (e.g., delay of cessation) potential public health consequences of e-cigarettes may be informed by studying dual users of e-cigarettes and tobacco cigarettes. A cross-sectional online survey assessed demographics, product use patterns, and beliefs about relative product benefits and harms among dual users (n = 350) in the United States using the website Amazon Mechanical Turk. Compared to tobacco cigarettes, e-cigarettes were used less often and were associated with lower dependence. Participants reported a 30% reduction in self-reported tobacco cigarette smoking since beginning to use e-cigarettes. Reported primary reasons for e-cigarette use were harm reduction and smoking cessation. E-cigarette use was reported as more likely in settings with smoking restrictions and when others' health could be adversely affected. Conversely, participants reported having used tobacco cigarettes more often than e-cigarettes in hedonic situations (e.g., after eating, drinking coffee or alcohol, or having sex), outdoors, or when stressed. Participants were twice as likely to report wanting to quit tobacco cigarettes compared to e-cigarettes in the next year and intended to quit tobacco cigarettes sooner. Tobacco cigarettes were described as more harmful and addictive, but also as more enjoyable than e-cigarettes. Participants provided evidence consistent with both positive and negative public health consequences of e-cigarettes, highlighting the need for experimental research, including laboratory studies and clinical trials. Policies should consider potential public health benefits of e-cigarettes, in addition to potential harms.
Tickle, J.; Sargent, J.; Dalton, M.; Beach, M.; Heatherton, T.
OBJECTIVE—To assess the relation between adolescents' favourite movie stars, the portrayal of tobacco use by those stars in contemporary motion pictures, and adolescent smoking. DESIGN AND SETTING—632 students (sixth to 12th grade, ages 10-19 years) from five rural New England public schools completed a voluntary, self administered survey in October 1996. The survey assessed tobacco use, other variables associated with adolescent smoking, and favourite movie star. In addition, tobacco use by 43 selected movie stars was measured in films between 1994 and 1996. OUTCOME MEASURES—Students were categorised into an ordinal five point index (tobacco status) based on their smoking behaviour and their smoking susceptibility: non-susceptible never smokers, susceptible never smokers, non-current experimenters, current experimenters, and smokers. We determined the adjusted cumulative odds of having advanced smoking status based on the amount of on-screen tobacco use by their favourite film star. RESULTS—Of the 43 stars, 65% used tobacco at least once, and 42% portrayed smoking as an essential character trait in one or more films. Stars who smoked more than twice in a film were considered smokers. For adolescents whose favourite stars smoked in only one film, the odds of being higher on the smoking index was 0.78 (95% confidence interval (CI) 0.53 to 1.15). For adolescents whose favourite stars smoked in two films, the odds of being higher on the smoking index was 1.5 (95% CI 1.01 to 2.32). For adolescents whose favourite stars smoked in three or more films (Leonardo DiCaprio, Sharon Stone, John Travolta), the odds of being higher on the smoking index was 3.1 (95% CI 1.34 to 7.12). Among never smokers (n = 281), those who chose stars who were smokers in three or more films were much more likely to have favourable attitudes toward smoking (adjusted odds ratio 16.2, 95% CI 2.3 to 112). CONCLUSIONS—Adolescents who choose movie stars who use tobacco
Medina, Krista Lisdahl; Nagel, Bonnie J.; Tapert, Susan F.
Background Functional neuroimaging data from adults have, in general, found frontocerebellar dysfunction associated with acute and chronic marijuana (MJ) use (Loeber & Yurgelun-Todd, 1999). One structural neuroimaging study found reduced cerebellar vermis volume in young adult MJ users with a history of heavy polysubstance use (Aasly et al., 1993). The goal of this study was to characterize cerebellar volume in adolescent chronic MJ users following one month of monitored abstinence. Method Participants were MJ users (n=16) and controls (n=16) aged 16-18 years. Extensive exclusionary criteria included history of psychiatric or neurologic disorders. Drug use history, neuropsychological data, and structural brain scans were collected after 28 days of monitored abstinence. Trained research staff defined cerebellar volumes (including three cerebellar vermis lobes and both cerebellar hemispheres) on high-resolution T1-weighted magnetic resonance images. Results Adolescent MJ users demonstrated significantly larger inferior posterior (lobules VIII-X) vermis volume (p<.009) than controls, above and beyond effects of lifetime alcohol and other drug use, gender, and intracranial volume. Larger vermis volumes were associated with poorer executive functioning (p’s<.05). Conclusions Following one month of abstinence, adolescent MJ users had significantly larger posterior cerebellar vermis volumes than non-using controls. These greater volumes are suggested to be pathological based on linkage to poorer executive functioning. Longitudinal studies are needed to examine typical cerebellar development during adolescence and the influence of marijuana use. PMID:20413277
Lopez-Larson, Melissa P.; Bogorodzki, Piotr; Rogowska, Jadwiga; McGlade, Erin; King, Jace B.; Terry, Janine; Yurgelun-Todd, Deborah
Introduction There are limited data regarding the impact of marijuana (MJ) on cortical development during adolescence. Adolescence is a period of substantial brain maturation and cortical thickness abnormalities may be indicative of disruptions of normal cortical development. This investigation applied cortical-surface based techniques to compare cortical thickness measures in MJ using adolescents compared to non-using controls. Methods Eighteen adolescents with heavy MJ use and 18 non-using controls similar in age received MRI scans using a 3T Siemens scanner. Cortical reconstruction and volumetric segmentation was performed with FreeSurfer. Group differences in cortical thickness were assessed using statistical difference maps covarying for age and gender. Results Compared to non-users, MJ users had decreased cortical thickness in right caudal middle frontal, bilateral insula and bilateral superior frontal corticies. Marijuana users had increased cortical thickness in the bilateral lingual, right superior temporal, right inferior parietal and left paracentral regions. In the MJ users, negative correlations were found between frontal and lingual regions for urinary cannabinoid levels and between age of onset of use and the right superior frontal gyrus. Conclusion This is one of the first studies to evaluate cortical thickness in a group of adolescents with heavy MJ use compared to non-users. Our findings are consistent with prior studies that documented abnormalities in prefrontal and insular regions. Our results suggest that age of regular use may be associated with altered prefrontal cortical gray matter development in adolescents. Furthermore, reduced insular cortical thickness may be a biological marker for increased risk of substance dependence. PMID:21310189
Coomber, Kerri; Toumbourou, John W.; Miller, Peter; Staiger, Petra K.; Hemphill, Sheryl A.; Catalano, Richard F.
Purpose: There are inconsistent research findings regarding the impact of rurality on adolescent alcohol, tobacco, and illicit substance use. Therefore, the current study reports on the effect of rurality on alcohol, tobacco, and illicit drug use among adolescents in 2 state representative samples in 2 countries, Washington State (WA) in the…
Park, Subin; Song, Hokwang
Drug abuse has been widely linked to suicide risk. We examined the factors that affect adolescent drug users' suicide attempts in South Korea. This study analyzed the data of 311 adolescents who had used drugs such as inhalants, psychotropic drugs, and marijuana (195 males and 116 females). Among 311 subjects, 109 (35.0%) had attempted suicide during the last 12 months. After adjusting for other variables, depressive mood (OR=19.79) and poly-drug use (OR=2.79), and low/middle levels of academic achievement compared with a high level (OR=3.72 and 4.38) were independently associated with increased odds of a suicide attempt, while better perceived health (OR=0.32) was independently associated with reduced odds of a suicide attempt. For adolescent drug users, preventive work should be directed toward the active treatment of drug use, depression, and physical health and reinforcing proper coping strategies for academic and other stress.
Wu, L T; Anthony, J C
OBJECTIVES: This study builds on previous observations about a suspected causal association linking tobacco smoking with depression. With prospective data, the study sheds new light on the temporal sequencing of tobacco smoking and depressed mood in late childhood and early adolescence. METHODS: The epidemiologic sample that was studied consisted of 1731 youths (aged 8-9 to 13-14 years) attending public schools in a mid-Atlantic metropolitan area, who were assessed at least twice from 1989 to 1994. A survival analysis was used to examine the temporal relationship from antecedent tobacco smoking to subsequent onset of depressed mood, as well as from antecedent depressed mood to subsequent initiation of tobacco use. RESULTS: Tobacco smoking signaled a modestly increased risk for the subsequent onset of depressed mood, but antecedent depressed mood was not associated with a later risk of starting to smoke tobacco cigarettes. CONCLUSIONS: This evidence is consistent with a possible causal link from tobacco smoking to later depressed mood in late childhood and early adolescence, but not vice versa. PMID:10589312
El-Bastawissi, A.; McAfee, T; Zbikowski, S; Hollis, J; Stark, M; Wassum, K; Clark, N; Barwinski, R; Broughton, E
Objective: To describe the experience of uninsured and Medicaid Oregon tobacco users who registered in Free & Clear (F&C), a telephone based cessation programme including five scheduled outbound calls. Design and setting: Using a retrospective cohort design, 1334 (423 uninsured, 806 Medicaid, and 105 commercially insured) Oregon tobacco users who registered in F&C between 18 November 1998 and 28 February 2000 were identified and followed for 12 months post-registration; 648 (48.6%) were successfully contacted at 12 months. Information was collected from the F&C database. Unconditional logistic regression, adjusted for race and education, was used. Results: The seven day quit rate at 12 months, assuming non-respondents were smokers, was 14.8% (95% confidence interval (CI) 13.0 to 16.9). This rate was significantly higher among commercially insured participants (v Medicaid but not uninsured) and among participants who completed ⩾ 5 calls (v < 5 calls). The quit rate for those contacted at 12 months was 30.6% (95% CI 27.0% to 34.3%) and varied, however not significantly, by insurance and number of calls. After adjustment, respondents who completed ⩾ 5 calls were 60% more likely to quit tobacco (odds ratio (OR) 1.6, 95% CI 0.9 to 3.1), and uninsured respondents who completed ⩾ 5 calls were 70% more likely to quit tobacco (OR 1.7, 95% CI 0.9 to 3.5), relative to those who completed < 5 calls, but the difference was not significant. Conclusions: The quit rates are similar to those reported in efficacy trials. The observed variation in quitting tobacco for respondents by number of calls completed and by insurance merits further investigation concentrating on increasing compliance with the call schedule, particularly for the uninsured. PMID:12612361
Liu, Jie; Lester, Barry M.; Neyzi, Nurunisa; Sheinkopf, Stephen J.; Gracia, Luis; Kekatpure, Minal; Kosofsky, Barry E.
Importance Animal studies have suggested that prenatal cocaine exposure (PCE) deleteriously influences the developing nervous system, in part attributable to its site of action in blocking the function of monoamine reuptake transporters, increasing synaptic levels of serotonin and dopamine. Objective To examine the brain morphologic features and associated impulsive behaviors in adolescents following prenatal exposure to cocaine and/or tobacco. Design Magnetic resonance imaging data and behavioral measures were collected from adolescents followed up longitudinally in the Maternal Lifestyle Study. Setting A hospital-based research center. Participants A total of 40 adolescent participants aged 13 to 15 years were recruited, 20 without PCE and 20 with PCE; a subset of each group additionally had tobacco exposure. Participants were selected and matched based on head circumference at birth, gestational age, maternal alcohol use, age, sex, race/ethnicity, IQ, family poverty, and socioeconomic status. Main Outcome Measures Subcortical volumetric measures of the thalamus, caudate, putamen, pallidum, hippocampus, amygdala, and nucleus accumbens; cortical thickness measures of the dorsolateral prefrontal cortex and ventral medial prefrontal cortex; and impulsivity assessed by Conners' Continuous Performance Test and the Sensation Seeking Scale for Children. Results After controlling for covariates, cortical thickness of the right dorsolateral prefrontal cortex was significantly thinner in adolescents following PCE (P=.03), whereas the pallidum volume was smaller in adolescents following prenatal tobacco exposure (P=.03). Impulsivity was correlated with thalamic volume following either PCE (P=.05) or prenatal tobacco exposure (P=.04). Conclusions and Relevance Prenatal cocaine or tobacco exposure can differentially affect structural brain maturation during adolescence and underlie enhanced susceptibility to impulsivity. Additional studies with larger sample sizes are
Williams, Melinda; Jones, Sandra C.; Caputi, Peter; Iverson, Don
Objective: To determine differences in sun-protection behaviours, and incidence of sunburn, between Australian adolescent female fake tan users and non-users. Design: Cross sectional survey. Method: 398 adolescent females aged 12 to 18 years participated in a survey at public venues, schools, and online. The main outcome measures were…
Panchmal, Ganesh Shenoy; Siddique, Sabin
Introduction: Biomarkers of tobacco exposure are used to confirm the absorption of specific smoke constituents in a quantitative manner. Materials and Methods: Periodontal status was measured by Community periodontal Index (WHO). Salivary thiocyanate was determined using spectrophotometric analysis, Salivary uric acid concentration was determined using the enzymatic uric acid assay reagent. pH was measured using pH strips. Results: Proportion of participants with periodontal pockets of 4-5mm was highest among tobacco smokers (80.0%) and periodontal pockets of 6mm or more were observed to be higher among tobacco chewers (26.67%). When LOA scores among tobacco chewers were recorded 26.7% of them presented with attachment loss of 0-3mm. 46.7% of them were affected with loss of attachment of 4-5mm and loss of attachment 6-8mm was found in 16.7%. 6.7% of them were found to be having loss of attachment of 9-11mm. 3.3% of them were found to be having loss of attachment of 12mm or more. The LOA scores in non- tobacco users showed 46.7% of 0-3mm, 50.0% of 4-5mm and 3.33% of 6-8mm attachment loss. The mean level of thiocyanate level detected in saliva of tobacco smokers was 172 ± 54.7 μg/ml and 203.70± 45.7 μg/ml in tobacco chewers. The mean uric acid levels was found to be 2.54 ±0.63 (μg/dl) in smokers and 2.65 ± 0.37(μg/dl) in chewers and in non tobacco users it was 2.33 ± 0.47 μg/dl. Conclusion: Tobacco users had significantly higher concentration of SCN levels than non-users. PMID:26393205
Nunez-Smith, Marcella; Wolf, Elizabeth; Huang, Helen Mikiko; Chen, Peggy G.; Lee, Lana; Emanuel, Ezekiel J.; Gross, Cary P.
The authors systematically reviewed 42 quantitative studies on the relationship between media exposure and tobacco, illicit drug, and alcohol use among children and adolescents. Overall, 83% of studies reported that media was associated with increased risk of smoking initiation, use of illicit drugs, and alcohol consumption. Of 30 studies…
Morrell, Holly E. R.; Lapsley, Daniel K.; Halpern-Felsher, Bonnie L.
Identifying factors that influence adolescents' decisions to start smoking is necessary to improve interventions for reducing tobacco use. The current longitudinal study was designed to determine the direction of influence between feelings of invulnerability to harm and cigarette smoking, and to test whether the perceived risks and benefits of…
Rantao, Masego; Ayo-Yusuf, Olalekan A.
Objectives: To determine factors associated with dual use of tobacco products in a population of black South African adolescents. Methods: Data were obtained from a self-administered questionnaire completed by a representative sample of grade 8 students from 21 randomly selected secondary state schools in the Limpopo Province, South Africa (n =…
Backinger, C; Fagan, P; Matthews, E; Grana, R
Data sources:Data were collected from published literature. Searches for adolescent prevention were conducted using PubMed, PsycInfo, and ERIC; and for cessation, PubMed, and two major reviews that span January 1978 to May 2002. PubMed, PsychInfo, and SCCI were searched for young adults from January 1990 to May 2002. Study selection:Data included smoking prevention studies published from January 1990 to May 2002 and conducted in the USA; all identified smoking cessation studies for adolescents. Young adult data were limited to initiation and cessation studies. Data extraction:Extraction of data was by consensus of the authors. Data synthesis:Results of the review are qualitative in nature using a consensus approach of the authors. Conclusions:School based curricula alone have been generally ineffective in the long term in preventing adolescents from initiating tobacco use but are effective when combined with other approaches such as media and smoke-free policies. Prevention research should consider multiple approaches and the social conditions that influence the development of youth problem behaviours including tobacco use. Because youth smoking cessation has been understudied to date, scientifically rigorous adolescent smoking cessation studies need to be conducted with attention to high risk smokers and less than daily smokers. Tobacco prevention and cessation for young adults needs focused attention. Prevention and cessation programmes need to address other tobacco products in addition to cigarettes. PMID:14645940
French, Doran C.; Purwono, Urip; Rodkin, Philip
The objectives of this longitudinal study were to predict the tobacco and alcohol use of Indonesian Muslim adolescents from their religiosity and the substance use of friends and network affiliates. At Year 1, there were 996 participants from eighth grade (n = 507, age = 13.4 years) and 10th grade (n = 489, age = 15.4); 875 were followed into the…
Belgrave, Faye Z.; Johnson, Jessica; Nguyen, Anh; Hood, Kristina; Tademy, Raymond; Clark, Trenette; Nasim, Aashir
Tobacco is a leading contributor to morbidity and mortality and a primary reason for health disparities among African Americans. In this study we explore the role of stress in smoking and cultural factors that protect against stress among African-American adolescents. Our sample consisted of 239 youth who were recruited into the study while…
Dunn, Michael S.; Kitts, Cathy; Lewis, Sandy; Goodrow, Bruce; Scherzer, Gary D.
Background: Alcohol, tobacco, marijuana use, and sexual behaviors are consistently reported by high school students in the United States and can contribute to reduced quality of life. Empirical research finds that many assets may act as a protective factor for adolescent risk behaviors. As such, the purpose of this study was to examine the…
Peterson, Emily Bylund; Thomsen, Steven; Lindsay, Gordon; John, Kevin
The objective of this study was determine if the inclusion of Canadian-style graphic images would improve the degree to which adolescents attend to, and subsequently are able to recall, novel warning messages in tobacco magazine advertising. Specifically, our goal was to determine if the inclusion of graphic images would 1) increase visual…
Nasim, Aashir; Belgrave, Faye Z.; Corona, Rosalie; Townsend, Tiffany G.
This study sought to determine the relative contributions of individual, family, peer, and community risk and promotive factors in explaining alcohol and tobacco refusal attitudes among 227 African-American adolescents (ages 12 to 17) from urban and rural areas. Hierarchical linear regression (HLR) results revealed differences in the predictive…
Swart, Dehran; Panday, Saadhna; Reddy, S Priscilla; Bergstrom, Erik; de Vries, Hein
This paper explores adolescent preferences for the setting, timing, delivery format, provider and key elements of tobacco control programmes. The need for programme sensitivity towards urban/rural, gender and ethnic subgroups is also discussed. Schools were purposively selected from the Southern Cape-Karoo Region, South Africa. Twelve prevention…
Scheer, Judith K.
The "Contemporary Health Series" covers critical health and family life topics in a sequence of modules with two curricular divisions: "Into Adolescence" for middle school teachers and "Entering Adulthood" for high school teachers. This module presents a tobacco "no use" message to students in grades five through eight through a series of eight…
Arora, Monika; Mathur, Manu Raj; Singh, Neha
The objective of this paper is to provide a comprehensive evidence based model aimed at addressing multi-level risk factors influencing tobacco use among children and adolescents with multi-level policy and programmatic approaches in India. Evidences around effectiveness of policy and program interventions from developed and developing countries were reviewed using Pubmed, Scopus, Google Scholar and Ovid databases. This evidence was then categorized under three broad approaches: Policy level approaches (increased taxation on tobacco products, smoke-free laws in public places and work places, effective health warnings, prohibiting tobacco advertising, promotions and sponsorships, and restricting access to minors); Community level approaches (school health programs, mass media campaigns, community based interventions, promoting tobacco free norms) and Individual level approaches (promoting cessation in various settings). This review of literature around determinants and interventions was organized into developing the IMPACT framework. The paper further presents a comparative analysis of tobacco control interventions in India vis a vis the proposed approaches. Mixed results were found for prevention and control efforts targeting youth. However, this article suggests a number of intervention strategies that have shown to be effective. Implementing these interventions in a coordinated way will provide potential synergies across interventions. Pediatricians have prominent role in advocating and implementing the IMPACT framework in countries aiming to prevent and control tobacco use among adolescents and children.
Tondowski, Cláudia S; Bedendo, André; Zuquetto, Carla; Locatelli, Danilo P; Opaleye, Emérita S; Noto, Ana R
The objective was to evaluate the relationship between tobacco use (previous month and frequent use), parenting styles and parental smoking behavior in a sample of high school students. Participants were recruited from public and private high schools from 27 Brazilian state capitals (N = 17,246). The overall prevalence of tobacco use in life was 25.2%; 15.3% in the previous year; 8.6% in the previous month; and 3.2% for frequent use. Tobacco use by the parents was reported by 28.6% of the students. Regarding parenting styles, 39.2% were classified as negligent, 33.3% authoritative, 15.6% as indulgent and 11.9% authoritarian. Compared to adolescents with authoritative parents, those with negligent or indulgent parents were more prone to report tobacco use during the last month or frequent use. This study showed an association between parenting styles and tobacco use by high school students. Authoritative parents were associated with protection from frequent and previous month tobacco use among adolescents.
Jackson, Kristina M.; Sher, Kenneth J.; Cooper, M. Lynne; Wood, Phillip K.
Aims We examined the alcohol-tobacco relationship using two prospective, ethnically diverse samples. Trajectories of alcohol and tobacco use are portrayed overall and by sex and ethnicity. Using prospective analyses, we examine directional influences between alcohol and tobacco use, and we characterize initiation versus persistence of drinking and smoking as a function of use of the other substance. Design, setting Data were from the National Longitudinal Study of Adolescent Health (AddHealth) and the Adolescent Health Risk Study (AHRS). Follow-up intervals for AddHealth and AHRS were 1 and 5 years, respectively. Participants AddHealth respondents (n = 4831) were on average 14.8 years old (48% male, 23% black, 61% white) and AHRS respondents (n = 1814) were on average 16.7 years old (47% male, 44% black, 49% white). Measurements Two alcohol consumption variables and two smoking variables were used: drinking frequency and heavy drinking frequency, and regular (current) smoking and daily number of cigarettes. Findings Alcohol and tobacco use exhibited monotonic increases over adolescence and young adulthood. Men and white respondents reported more use than women and black respondents. Alcohol and tobacco were moderately associated at both times. Analyses revealed that prior alcohol use predicted tobacco use more strongly than the converse. Initiation of smoking was a function of prior drinking; to a lesser extent, initiation of drinking was a function of prior smoking. Persistence of smoking was a function of prior drinking and persistence of drinking was a function of prior smoking. Conclusions Provisional support exists for the claim that alcohol use predicts tobacco use more strongly than the converse. For both drinking and smoking, onset and persistence are predicted by prior use of the other substance, and these associations were robust across sex and ethnicity. PMID:12033653
Creath, Curtis J.; And Others
Survey of high school football players (n=1,116) found that, compared to nonusers, adolescent athletes who tried smokeless tobacco were more likely to be white; to use cigarettes, alcohol, and cigars; and to have family users. Initial use was highest before age 14. Differences were found between snuff users and users of chewing tobacco. (Author/NB)
Hong, Rei-Mei; Guo, Su-Er; Chen, Mei-Yen
Most smokers start young. Initiation of cigarette smoking at an earlier age leads to more life-years for tobacco use, makes quitting harder, and increases the risk of serious health consequences. Despite these challenges, research focusing on smoking behavior among adolescent boys in Taiwan is rare. Although the Taiwanese government enacted the Tobacco Hazards Prevention Act in 2009, aimed at prevention and reducing the rate of smoking, the percentage of high school students who smoke has continued to increase. In 2006, 7.5% of adolescent boys engaged in smoking. By 2012 the rate had increased to 24.6%. This paper explores the experiences that contribute to adolescent Taiwanese boys making the decision to smoke. A phenomenological approach to inquiry was used as the philosophical foundations for this study with twelve adolescent boys who engaged in smoking behaviors. Data was gathered through two face-to-face semi-structured interviews and a focus group. Data analysis was performed using Colaizzi’s analysis method. Findings indicated that decisions to begin smoking were motivated by curiosity and as a means of establishing friendships while decisions to continue smoking were linked to the addictive nature of smoking and as a means of coping with stress and passing the time. The findings can be used to inform the prevention of tobacco use and to reduce the high smoking rates among adolescent boys. PMID:26343695
Binnal, Almas; Ahmed, Junaid; Denny, Ceena
Introduction Global Smokeless Tobacco (SLT) consumption is on the rise and constitutes a major Public Health problem. Controlling SLT intake is central to containing the increasing tobacco menace. Aim The present study was undertaken to comprehensively explore various factors involved in SLT consumption and its cessation among current SLT users. Materials and Methods Present study was conducted among current SLT users visiting Department of Oral Medicine and Radiology, Manipal College of Dental Sciences (MCODS), Manipal University, Mangalore, Karnataka, India. A structured, pretested and self-administered questionnaire was employed for the present study. Knowledge, attitude, behaviour, worksite practices of respondents towards SLT consumption and its cessation, barriers to SLT cessation were explored. Information about socio-demographic variables was also collected. Results Overall, 170 current SLT users participated in the present study. Results revealed that the mean knowledge, attitude, worksite related practices and barrier scores were 9.96(55.33%), 48.89(81.48%), 2.70(33.75%) and 54.25(60.27%) respectively. Correlation analysis revealed significant association of socio-demographic factors with knowledge, attitude and worksite related practices (p<0.05). SLT cessation related practices revealed that majority wished to quit (90%) and significant associations were noted amongst wish to quit with higher attitude scores; actual quit attempts with higher attitude, lower barrier scores and difficulty to quit with higher barrier scores (p<0.05). Conclusion The present study draws attention towards involvement of complex interactions of various parameters including socio-demographic factors in SLT consumption and its cessation. Hence, it is imperative to implement multifactorial SLT control approach in order to contain tobacco menace spread across the globe. PMID:27891470
Jain, Raka; Jhanjee, Sonali; Jain, Veena; Gupta, Tina; Mittal, Swati; Chauhan, Prashant; Raghav, Rahul; Goelz, Patricia; Schnoll, Robert A
The validity of self-reported tobacco use is often questioned given the potential for underestimation of use. This study used data from a double-blind, placebo-controlled clinical trial of varenicline for smokeless tobacco dependence in India to evaluate the accuracy of self-reported smokeless tobacco cessation using biochemical validation procedures and to evaluate correlates of reporting inaccuracy. Smokeless tobacco users attending a dental clinic at AIIMS were randomized to placebo or varenicline; all participants received counseling. Detailed smokeless tobacco use was recorded and abstinence was defined as cotinine-verified 7-day point prevalence cessation (cotinine < 50 ng/ml) and breath CO > 10 ppm at the end of 12 weeks of treatment. One-half of study completers (82/165) self-reported abstinence. Biochemical verification confirmed that (65.9%) subjects provided accurate self-reports while (34.1%) participants underreported tobacco use. These data indicate poor agreement between self-reported and biochemically confirmed abstinence (κ = -0.191). Underreporters of tobacco use had significantly higher baseline cotinine (p < 0.05), total craving (p < 0.012), and negative reinforcement craving (p < 0.001) vs. those whose self-reports were correctly verified. These findings provide evidence to support the need for biochemical validation of self-reported abstinence outcomes among smokeless tobacco users in cessation programs in India and identify high levels of pretreatment cotinine and craving levels as potential correlates of false reporting.
Dhumal, Gauri G.; Pednekar, Mangesh S.; Gupta, Prakash C.; Sansone, Genevieve C; Quah, ACK; Bansal-Travers, M; Fong, Geoffrey T
Background GATS India 2009–10 revealed that more than one-third (35%) of adults in India use tobacco in some form: 21% use smokeless tobacco, 9% smoke, and 5% are mixed users (they smoke and use smokeless tobacco), and the quit rate is very low. In an effort to decrease prevalence of tobacco use, it is thus important to understand the factors that are related to intention to quit among Indian tobacco users. Research has shown consistently that intention to quit is a strong predictor of future quitting. The present study reports the factors encouraging quitting tobacco products in India. Methods Cross-sectional data from Wave 1 of the International Tobacco Control Policy Evaluation (TCP) India Survey conducted in four cities and surrounding rural areas [i.e. Mumbai (Maharashtra), Patna (Bihar), Indore (Madhya Pradesh), and Kolkata (West Bengal)] between August 2010 and December 2011 were analyzed. A total of 8,051 tobacco users (15+ years) were randomly sampled from 8,586 households: 1,255 smokers, 5,991 smokeless users, and 805 mixed (smoke and smokeless) users. Validated, standardized questions were asked about current tobacco use, intention to quit, and factors encouraging quitting. Results Overall, 19.6% of tobacco users intended to quit. Smokers had less intention to quit as compared to smokeless tobacco users whereas mixed users had more intention to quit (OR = 1.48, 95% CI = 1.12–1.97) compared to smokeless tobacco users. Highly educated people were more likely to report intention to quit (OR = 1.82, 95% CI = 1.09–3.02) compared to less educated. Advice by doctors to quit tobacco had a strong impact on intention to quit (OR = 1.68, CI = 1.29–2.15). Tobacco users who were exposed to anti-tobacco messages at work places (OR = 1.74, CI = 1.23–2.46), at restaurants (OR = 1.65, CI = 1.12–2.43), bars (OR = 1.81, CI = 1.07–3.06), on public transportation (OR = 2.14, CI = 1.49–3.08) and on tobacco packages (OR = 1.77, CI = 1.29–2.14) also expressed
Brown, Abraham; Moodie, Crawford
Using cross-sectional data from three waves of the Youth Tobacco Policy Study, which examines the impact of the UK's Tobacco Advertising and Promotion Act (TAPA) on adolescent smoking behaviour, we examined normative pathways between tobacco marketing awareness and smoking intentions. The sample comprised 1121 adolescents in Wave 2 (pre-ban), 1123 in Wave 3 (mid-ban) and 1159 in Wave 4 (post-ban). Structural equation modelling was used to assess the direct effect of tobacco advertising and promotion on intentions at each wave, and also the indirect effect, mediated through normative influences. Pre-ban, higher levels of awareness of advertising and promotion were independently associated with higher levels of perceived sibling approval which, in turn, was positively related to intentions. Independent paths from perceived prevalence and benefits fully mediated the effects of advertising and promotion awareness on intentions mid- and post-ban. Advertising awareness indirectly affected intentions via the interaction between perceived prevalence and benefits pre-ban, whereas the indirect effect on intentions of advertising and promotion awareness was mediated by the interaction of perceived prevalence and benefits mid-ban. Our findings indicate that policy measures such as the TAPA can significantly reduce adolescents' smoking intentions by signifying smoking to be less normative and socially unacceptable.
Johns, Michael; Sacks, Rachel; Rane, Madhura; Kansagra, Susan M
This study was designed to estimate the relationship between exposure to tobacco retail outlets and smoking initiation in a racially diverse urban setting. Using data from the 2011 NYC Youth Risk Behavior Survey, multivariable logistic regression analyses were conducted to estimate the exposure-initiation relationship and test for effect modification, while controlling for covariates. The predicted probability of smoking initiation from the multivariable model increased from 7.7 % for zero times a week exposed to tobacco retailers to 16.0 % for exposure seven times or more per week. The odds of initiation were significantly higher among adolescents exposed to tobacco retail outlets two times or more a week compared with those exposed less often (AOR = 1.41; 95 % CI: 1.08, 1.84). Risk-taking behavior modified the relationship between exposure and initiation, with the odds of initiation highest among those low in risk-taking (AOR = 1.78; 95 % CI: 1.14, 1.56). These results are consistent with past research, showing that frequent exposure to tobacco marketing in retail settings is associated with increased odds of initiation. Reducing exposure to tobacco retail marketing could play an important role in curtailing smoking among adolescents, especially those less prone to risk-taking.
Julià Cano, Albert; Escapa Solanas, Sandra; Marí-Klose, Marga; Marí-Klose, Pau
There are multiple factors that can affect the risk of tobacco use in adolescence. By analyzing these factors together we can disentangle the specific relevance of each of them in shaping teenagers' individual behavior. The goal of this research study is to deepen our understanding of the relationship between tobacco use in adolescence and socio-demographic and socio-emotional variables. We worked with a representative sample of 2,289 Catalan teenagers (aged 15-18) who responded to a questionnaire drawn up by the Families and Children Panel. Regression models were developed to assess the statistical associations of different mood states (sadness, nervousness and loneliness), peer-group characteristics and parenting styles, with tobacco use. The results indicate that addictive behavior is more likely when teenagers show negative mood states, controlling for socio-demographic variables and other risk factors. Among these additional factors, authoritative parenting styles reduce the risk of tobacco use, compared to authoritarian, permissive and neglectful parenting. Extensive tobacco use within the peer group is the risk factor most strongly associated with teenagers' individual behavior.
Henriksen, Lisa; Feighery, Ellen C.; Wang, Yun; Fortmann, Stephen P.
A survey of 2125 middle-school students in central California examined adolescents’ exposure to tobacco marketing in stores and its association with self-reported smoking. Two thirds of sixth-, seventh-, and eighth-grade students reported at least weekly visits to small grocery, convenience, or liquor stores. Such visits were associated with a 50% increase in the odds of ever smoking, even after control for social influences to smoke. Youth smoking rates may benefit from efforts to reduce adolescents’ exposure to tobacco marketing in stores. PMID:15569957
Hiratsuka, Vanessa Y.; Suchy-Dicey, Astrid M.; Garroutte, Eva M.; Booth-LaForce, Cathryn
Introduction Tobacco use is the leading behavioral cause of death among adults 25 years or older. American Indian (AI) and Alaska Native (AN) communities confront some of the highest rates of tobacco use and of its sequelae. Primary care–based screening of adolescents is an integral step in the reduction of tobacco use, yet remains virtually unstudied. We examined whether delivery of tobacco screening in primary care visits is associated with patient and provider characteristics among AI/AN adolescents. Methods We used a cross-sectional analysis to examine tobacco screening among 4757 adolescent AI/AN patients served by 56 primary care providers at a large tribally managed health system between October 1, 2011 and May 31, 2014. Screening prevalence was examined in association with categorical patient characteristics (gender, age, clinic visited, insurance coverage) and provider characteristics (gender, age, tenure) using multilevel logistic regressions with individual provider identity as the nesting variable. Results Thirty-seven percent of eligible patients were screened. Gender of both providers and patients was associated with screening. Male providers delivered screening more often than female providers (odds ratio [OR] 1.6, 95% confidence interval [CI] 0.7–3.9). Male patients had 20% lower odds of screening receipt (OR 0.8, 95% CI 0.7–0.9) than female patients, independent of patient age and provider characteristics. Individual provider identity significantly contributed to variability in the mixed-effects model (variance component 2.2; 95% CI 1.4–3.4), suggesting individual provider effect. Conclusions Low tobacco screening delivery by female providers and the low receipt of screening among younger, male patients may identify targets for screening interventions. PMID:26319931
Puckett, Mary; Neri, Antonio; Thompson, Trevor; Underwood, J Michael; Momin, Behnoosh; Kahende, Jennifer; Zhang, Lei; Stewart, Sherri L
Smoking caused an average of 480,000 deaths per year in the United States from 2005 to 2009, and three in 10 cancer deaths in the United States are tobacco related. Tobacco cessation is a high public health priority, and all states offer some form of tobacco cessation service. Quitlines provide telephone-based counseling services and are an effective intervention for tobacco cessation. In addition to telephone services, 96% of all U.S. quitlines offer Web-based cessation services. Evidence is limited on the number of tobacco users who use more than one type of service, and studies report mixed results on whether combined telephone and Web-based counseling improves long-term cessation compared with telephone alone. CDC conducted a survey of users of telephone and Web-based cessation services in four states to determine the cessation success of users of these interventions. After adjusting for multiple variables, persons who used both telephone and Web-based services were more likely to report abstinence from smoking for 30 days at follow up (odds ratio = 1.3) compared with telephone-only users and with Web-only users (odds ratio = 1.5). These findings suggest that states might consider offering both types of cessation services to increase cessation success.
Rial, Antonio; Gómez, Patricia; Picón, Eduardo; Braña, Teresa; Varela, Jesús
The percentages of adolescent Internet use in general terms have been measured for nearly two decades now; however, it might be thought that not every teenager behaves online in the same way. This study aims to identify the different types or profiles of adolescents and to characterize them from an attitudinal, behavioral and socio-demographic viewpoint. A questionnaire was applied to a representative sample of 2,339 Compulsory Secondary School students (M = 13.77 years old) from Galicia (a North-Western region of Spain) for this purpose. A two-stage cluster analysis, based on the response pattern in relation to their attitudes toward Internet, was carried out. Four different segments with specific characteristics were identified: the first steppers, the trainees, the sensible users, and the heavy users. Besides the relevance of descriptive data, these results are of particular interest at an applied level, because they could lead to a better fit of programs to prevent risky behaviors and problematic Internet use in adolescents.
Papadakis, Sophia; Tulloch, Heather E.; Gharib, Marie; Pipe, Andrew L.
Background: The aim of this study was to document the prevalence of tobacco use and describe the characteristics of tobacco users identified in primary care practices. Methods: We conducted a cross-sectional survey in 49 primary care practices in the province of Ontario. Consecutive patients were screened for smoking status at the time of their clinic appointment. Patients reporting current tobacco use completed a survey, which documented sociodemographic and smoking-related characteristics. Multilevel modelling was used to examine predictors of readiness to quit smoking and the presence of anxiety and/or depression. Results: A total of 56 592 patients were screened, and 5245 tobacco users participated in the survey. Prevalence of tobacco use was 18.2% and varied significantly across practices (range 12.4%-36.1%). Of the respondents, 46.3% reported current anxiety and/or depression, and 61.3% reported smoking within the first 30 minutes of waking. A total of 41.1% of respondents reported they were ready to quit smoking in the next 6 months, and 30.1% reported readiness to quit in the next 30 days. Readiness to quit was positively associated with higher self-efficacy, male sex, presence of chronic obstructive pulmonary disease and more years of tobacco use. The presence of anxiety and/or depression was associated with lower cessation self-efficacy and time to first cigarette within 30 minutes of waking, but did not predict readiness to quit. Interpretation: Tobacco users identified in primary care practices reported high rates of nicotine dependence and anxiety and/or depression, but also high rates of readiness to quit. Study findings support the need to tailor interventions to address the needs of tobacco users identified in primary care settings. PMID:27280113
Banerjee, Smita C; Ostroff, Jamie S; D'Agostino, Thomas A; Bari, Sehrish; Khera, Mitali; Acharya, Sudha; Gany, Francesca
Gutka and tambaku paan (smokeless tobacco products used by South Asian immigrants) are carcinogenic to humans (and perceived as such), yet, one-fourth of South Asian immigrants report current use. This study examined disengagement beliefs that perpetuate gutka/tambaku paan use among South Asians despite awareness of health risks. Six focus groups were conducted with immigrant South Asian adult gutka/tambaku paan users, in Gujarati, Bengali and Urdu languages in New York, USA. Participants included 39 South Asian adults residing in the New York City Metropolitan area, current (a minimum of weekly gutka or tambaku paan use in the last 12 months) or former (regular use prior to past 12 months) gutka or tambaku paan users and self-reported spoken fluency in Gujarati, Urdu or Bengali languages. Participants identified many health risks associated with gutka/tambaku paan use including locked jaw, high blood pressure and cancer. Five themes of disengagement beliefs emerged: (a) skepticism about the gutka/tambaku paan-cancer link, (b) perceived invulnerability to harm, (c) compensatory beliefs, (d) faith-based rationalization and (e) acknowledgment of addiction. To promote smokeless tobacco cessation among South Asians, interventions to counter disengagement beliefs and heighten the discomfort between the dissonant cognitions represent a promising area warranting further attention.
Wiener, R. Constance
Background Using smokeless tobacco and smoking are risk behaviors for oral cancer, soft tissue lesions, caries, periodontal disease and other oral conditions. The purpose of this study was to examine adolescent smokeless tobacco use and smoking. Methods The study was a cross-sectional analysis of participants with complete data on smoking, smokeless tobacco use, and other variables of interest in the 2011 Youth Risk Behavior Survey (n=9655). Descriptive analysis and multivariable logistic regression analyses were performed. Results The unadjusted odds ratio for smokeless tobacco use and smoking was 9.68 (95% CI: 7.72, 12.13, p<.0001); the adjusted odds ratio was 3.92 (95%CI: 2.89, 5.31, p<.0001). Adolescents using smokeless tobacco were more likely to be male, to smoke, and to have engaged in binge drinking. Conclusions Adolescents who are using smokeless tobacco are more likely to also be engaging in concomitant smoking and are participating in other risk-taking behaviors. Practice implications Dentists are involved in helping patients in tobacco cessation. The strong association of smoking with smokeless tobacco needs to be considered in designing cessation programs for adolescents. PMID:23904581
Weaver, Andrew J.; Flannelly, Kevin J.; Strock, Adrienne L.
An electronic search of Medline and PsycInfo produced 29 studies that specifically investigated the effects of religion on adolescent tobacco use. Independent (religion) and dependent (tobacco use) variables and variables controlled for in statistical analyses were categorized. Twenty-two of the 29 studies reported at least one significant effect…
Paek, Hye-Jin; Hove, Thomas; Oh, Hyun Jung
Background: In efforts to curb and prevent youth smoking, school tobacco policies have become an important and effective strategy. This study explores the degrees and types of tobacco-free school policy (TFSP) enforcement that are associated with adolescent smoking. Methods: A multilevel analysis was performed using 983 students who are nested in…
... from poor households are frequently employed in tobacco farming to provide family income. These children are especially ... 19% of the world's population, meet the best practice for pictorial warnings, which includes the warnings in ...
Chuang, Cheng-Wei I.; Chan, Connie; Leventhal, Adam M.
OBJECTIVE Use of drugs and alcohol, including tobacco, is linked to adolescent emotional psychopathology. Given that tobacco use is becoming less common over recent years, its co-use with drugs/alcohol may mark a more severe profile of emotional symptomatology. However, it is unclear whether teens with a lifetime history of using drugs/alcohol and tobacco exhibit additional elevations in emotional psychopathology and/or multiple forms of emotional psychopathology compared to teens with lifetime drugs/alcohol use without comorbid tobacco use. This cross-sectional study compared emotional disorder symptoms and emotional vulnerability traits among adolescents with varying histories of substance use. METHODS Ninth-grade students enrolled at two schools in Los Angeles, CA were recruited; 575 met eligibility criteria and provided both student assent and parental consent. Students completed self-report measures of emotional pathology, trans-diagnostic, and lifetime substance use. Participants were classified into three groupings: (1) no history of substance use (n=294); (2) lifetime history of drug/alcohol use without tobacco use (n=166); and (3) lifetime history of drug/alcohol use with concomitant tobacco use (n=115). RESULTS Of those with a history of substance use, teens with lifetime alcohol/drug use with (vs. without) comorbid tobacco use were more likely to have used substances. Compared to students with no history of substance use, those with any history of use (alcohol/drugs with and without tobacco use) had higher major depression symptoms and negative affect; those with lifetime alcohol/drug use with comorbid tobacco use had higher generalized anxiety symptoms and distress; those with lifetime alcohol/drug use without comorbid tobacco use had higher panic disorder symptoms and anhedonia. There were no significant differences between adolescents with lifetime drug/alcohol use with comorbid tobacco use versus those without tobacco use. CONCLUSIONS Adolescents
Jacobs, Wura; Goodson, Patricia; Barry, Adam E.; McLeroy, Kenneth R.
Background: Despite previous research indicating an adolescents' alcohol, tobacco, and other drug (ATOD) use is dependent upon their sex and the sex composition of their social network, few social network studies consider sex differences and network sex composition as a determinant of adolescents' ATOD use behavior. Methods: This systematic…
Mejia, Raul; Ferrante, Daniel; De Maio, Fernando G.; Diez Roux, Ana V.
Introduction: The relationship between poverty and tobacco consumption among adolescents has not been extensively studied, and what evidence exists has come almost entirely from developed countries. Moreover, the impact of contextual factors—such as school-level poverty—remains unclear. Methods: We obtained information about smoking behavior from the Global Youth Tobacco Survey in Argentina in 2007. School-level characteristics were derived by matching schools to census areas from the 2001 Census. Additional school-level information was obtained from the Ministry of Education. Random intercept models were used to evaluate the associations of school-level variables (poverty in the census area of the school, school receipt of social assistance, and public or private status) with current smoking, intention to quit, secondhand smoke exposure outside the home, support for smoke-free laws, purchase of single cigarettes among smokers, and susceptibility to smoking in 5 years among nonsmokers. Results: After controlling for age and sex, students attending schools receiving social assistance were more likely to smoke (odds ratio [OR] 1.35, 95% CI 1.02–1.80) and to purchase loose cigarettes (OR 1.66, 95% CI 1.08–2.54), whereas school poverty was significantly associated with secondhand smoke exposure (OR 1.27, 95% CI 1.04–1.58). Conclusion: This study shows that an association exists between unfavorable contextual school characteristics and tobacco consumption and related measures among youth in Argentina. Efforts to prevent smoking may need to address the school-level factors that place youth at higher risk. PMID:22394595
Fairman, Brian J.
Background In most of the world, cannabis smokers mix loose tobacco inside a joint, pipe, spliff, or cone. More recently, a ‘blunt’ formulation combines these two drugs by inserting cannabis into a hollowed-out cigar. Epidemiological research linking simultaneous use of these two drugs and the development of cannabis use disorders (CUD) remains unclear. This study estimates associations linking blunt smoking with levels and subtypes of cannabis problems. Methods Cross-sectional data on 27,767 past-year cannabis users were analyzed from the US National Survey on Drug Use and Health (NSDUH) conducted from 2009–2012. Ten self-reported items of DSM-IV CUD features elicited a single latent trait of cannabis problem (CP) severity, which was then regressed on past-year blunt smoking and past-month blunt frequency measures within the context of a conceptual model. Differential item functioning (DIF) analysis evaluated potential bias in CP feature response by blunt smoking history. Results Past-year blunt smoking was associated with higher CP severity compared to cannabis users who did not smoke blunts. Days of blunt smoking in the past month also predicted higher CP severity than less frequent blunt use. Those smoking blunts experienced more subjectively felt tolerance and having spent more time obtaining or using cannabis, but were less likely to experience other problems, even at the same level of CP severity. Conclusions These findings suggest smoking blunts might promote the development of problematic cannabis use. Responses to cannabis problems differed by history of blunt smoking, possibly implicating an influence of tobacco on measurement of cannabis use disorders. PMID:25746234
Impey, Danielle; El-Marj, Nicole; Parks, Andrea; Choueiry, Joelle; Fisher, Derek; Knott, Verner J
Chronic cannabis use may interact with factors, such as age of onset of cannabis use, family history, and genetic factors, to elicit schizophrenia (SZ)-like symptoms, including sensory and cognitive deficits. However, evidence of a relationship between cannabis use and cognitive impairment is confounded by concomitant use of tobacco. The objective of this study was to compare tobacco-naïve cannabis users with individuals without a history of tobacco/cannabis use on the auditory mismatch negativity (MMN) event-related potential (ERP), a neural measure of auditory deviance detection which is diminished in SZ. An exploratory arm of the study, conducted within a randomized, double-blind, placebo controlled design, examined the acute effects of nicotine gum (6mg) on MMN in cannabis users. MMN was recorded in response to 5 deviant stimuli within an optimal MMN paradigm in 44 healthy, non-tobacco smoking volunteers aged 18-26. Cannabis users (n=21) started smoking cannabis prior to age 17, at least 1 joint per month. To examine the effects of chronicity, users were grouped into relatively heavy long-term (HLT; n=11) users and light short-term (LST; n=10) users. Impaired deviance detection was shown in cannabis users vs. nonusers as reflected by a smaller MMN to duration deviants. Chronicity of use was also associated with MMN alterations, as HLTs displayed a reduced duration and gap MMN vs. LSTs. Compared with placebo, nicotine treatment enhanced select MMN deviants in cannabis user subgroups. As deficits associated with early and persistent cannabis use are similar to those seen in SZ, these dose-dependant disturbances in early sensory processing with cannabis use may be one cognitive pathway which mediates an increased risk for SZ in vulnerable youth, and be influenced by concurrent cigarette smoking behavior.
Udayashankar, Urmila; Guduru, Vijay Srinivas; Ananthaneni, Anuradha; Ramisetty, Sabitha Devi; Kuberappa, Puneeth Horatti; Namala, Srilekha
Aims: To determine the cellular and nuclear area of keratinocytes in smears obtained from the oral mucosa of tobacco users, those with oral squamous cell carcinoma (OSCC), and from normal healthy persons and resolve if any significant difference exists in these three groups. Materials and Methods: The study group comprised 100 subjects 20 controls, (40 OSCC patients-20 from lesional sites and 20 from nonlesional sites, 20 tobacco smokers and 20 tobacco chewers) in the age group of 25-75 years. Oral mucosal smears obtained by using a cytobrush were stained with Papanicolaou (PAP) stain and using 20X objective in trinocular Olympus model BX53 with Jenoptik scientific grade-dedicated microphotographic camera images were taken. With ProgRes version 8.0 image analysis software, 20 cells with defined borders were evaluated from each slide. Finally, one-way analysis of variance (ANOVA) was used to compare the above parameters in the studied groups. Statistical Analysis Used: Minitab and Excel software were used to analyze the data. One-way ANOVA was used to compare the above parameters in the studied groups. Results: The mean value of the cell area for groups I, II, III, IV, and V were 2838 ± 275.2, 2762.1 ± 511.4, 2861.9 ± 512.9, 2643.8 ± 333.3, and 3064.3 ± 362.7, respectively, the nuclear area (NA) was 83.88 ± 9.86, 106.19 ± 13.45, 95.11 ± 14.24, 85.55 ± 21.11, and 80.83 ± 13.45, respectively, and nuclear-to-cellular (N:C) ratio was 0.0297, 0.03924, 0.0337, 0.03257, and 0.02678, respectively. Conclusions: Thus, our study elucidates that cytomorphology gauges the effect of tobacco on the oral mucosa and possibly establishes a link between premalignant and malignant transformations even before a lesion is visibly noted. PMID:27756983
Chenoweth, Meghan J.; Sylvestre, Marie-Pierre; Contreras, Gisele; Novalen, Maria; O’Loughlin, Jennifer; Tyndale, Rachel F.
Background Smoking is influenced by genetic factors including variation in CYP2A6 and CYP2B6, which encode nicotine-metabolizing enzymes. In early adolescence, CYP2A6 slow nicotine metabolism was associated with higher dependence acquisition, but reduced cigarette consumption. Here we extend this work by examining associations of CYP2A6 and CYP2B6 with tobacco dependence acquisition in a larger sample of smokers followed throughout adolescence. Methods White participants from the Nicotine Dependence in Teens cohort that had ever inhaled (n=421) were followed frequently from age 12–18 years. Cox’s proportional hazards models compared the risk of ICD-10 tobacco dependence acquisition (score 3+) for CYP2A6 and CYP2B6 metabolism groups. Early smoking experiences, as well as amount smoked at end of follow-up, was also computed. At age 24 (N=162), we assessed concordance between self-reported cigarette consumption and salivary cotinine. Results In those who initiated inhalation during follow-up, CYP2A6 slow (vs. normal) metabolizers were at greater risk of dependence (hazards ratio (HR)=2.3; 95% CI=1.1, 4.8); CYP2B6 slow (vs. normal) metabolizers had non-significantly greater risk (HR=1.5; 95% CI=0.8, 2.6). Variation in CYP2A6 or CYP2B6 was not significantly associated with early smoking symptoms or cigarette consumption at end of follow-up. At age 24, neither gene was significantly associated with dependence status. Self-reported consumption was associated with salivary cotinine, a biomarker of tobacco exposure, acquired at age 24 (B=0.37; P<0.001). Conclusions Our findings extend previous work indicating that slow nicotine metabolism mediated by CYP2A6, and perhaps CYP2B6, increases risk for tobacco dependence throughout adolescence. PMID:26644138
Vaughn, Michael G.; Salas-Wright, Christopher P.; Kremer, Kristen P.; Maynard, Brandy R.; Roberts, Greg; Vaughn, Sharon
Background Nearly two million school-aged children in US are currently homeschooled. This study seeks to examine homeschooled adolescents’ attitudes toward, access to, and use of alcohol, tobacco, and other drugs (ATOD) compared to their non-homeschooled peers. Methods The study uses data between 2002 and 2013 from the National Survey on Drug Use and Health (NSDUH) for school-attending respondents aged 12–17 (n = 200,824). Participants were questioned regarding peer use of licit and illicit substances, ease of accessing illicit substances, and past 12-month substance use. Survey adjusted binary logistic regression analyses were systematically executed to compare non-homeschooled adolescents with homeschooled adolescents with respect to views toward, access to, and use of substances. Results Findings indicate that homeschooled adolescents were significantly more likely to strongly disapprove of their peers drinking (AOR = 1.23) and trying (AOR = 1.47) and routinely using (AOR = 1.59) marijuana. Homeschooled adolescents were significantly less likely to report using tobacco (AOR = 0.76), alcohol (AOR = 0.50), cannabis (AOR = 0.56) and other illicit drugs and to be diagnosed with an alcohol (AOR = 0.65) or marijuana (AOR = 0.60) use disorder. Finally, homeschooled adolescents were also less likely to report easier access to illicit drugs and to be approached by someone trying to sell drugs compared to non-homeschooled peers. Conclusions Homeschooled adolescents’ views, access, use and abuse of ATOD are uniquely different from those of non-homeschooled adolescents. Findings point to the need to more extensively examine the underlying mechanisms that may account for these differences. PMID:26338482
Van Ryzin, Mark J.; DeLay, Dawn; Dishion, Thomas J.
Although substance use has traditionally been linked to peer deviance, a parallel literature has explored the influence of peer social status (being “well-liked”). This literature hypothesizes that adolescents with higher status will anticipate shifts in social norms and modify their behavior earlier and/or more substantially than lower-status students. As substance use becomes more socially acceptable during early-to-mid-adolescence, higher status youth are hypothesized to reflect this shift in norms by accelerating their use. Although some evidence exists to support this hypothesis, it has never been evaluated in conjunction with the opposing hypothesis (i.e., that substance use contributes to elevated peer status). In this study, we evaluated reciprocal links between peer status and substance use (i.e., alcohol and tobacco) using 3 years of data from a sample of adolescents attending 8 middle schools in the Pacific Northwest. Social network analysis enabled us to model standard network effects along with unique effects for the influence of the network on behavior (i.e., increased substance use as a result of being well-liked) and the influence of behavior on the network (i.e., increased status as a result of substance use). Our results indicated significant bidirectional effects for alcohol use but no significant effects for tobacco use. In other words, being well-liked significantly predicted alcohol use and vice versa, but these processes were not significant for tobacco use. Prevention efforts should consider the dynamics of peer status and peer norms in adolescence with the goal of preventing escalations in problem behavior that can compromise future adjustment. PMID:26547042
Bottorff, Joan L; Poole, Nancy; Kelly, Mary T; Greaves, Lorraine; Marcellus, Lenora; Jung, Mary
Adolescent girls are more likely than women of other ages to smoke tobacco or drink alcohol during pregnancy. The health impacts of smoking and drinking for girls and the interconnections between alcohol and tobacco use with adolescent pregnancy underscore the urgent need for integrated approaches to prevent and reduce alcohol and tobacco use among pregnant girls/young women. This article reports on the results of a scoping review of the literature focused on adolescents’ use of tobacco and alcohol during pregnancy and postpartum. A search of CINAHL, Medline, Social Science Index and Web of Science identified 40 articles published in the two decades between 1990 and 2012 that met our inclusion criteria related to this age group, pregnancy/motherhood status, and use of both alcohol and tobacco. The review points to compelling gaps in our knowledge and our responsiveness to adolescents aged 19 and under who use alcohol and tobacco during pregnancy and the postpartum period. Research has been primarily descriptive, with separate, parallel streams of investigation to identify trends and predictors of alcohol and tobacco use, prior to, during and following pregnancy. There is a marked lack of effective interventions described in the literature that are designed to prevent or reduce alcohol and tobacco use during pregnancy among adolescent girls; and there are few examples of gender-informed prevention or treatment programmes for this population. Research is needed on interventions that attend to the context of adolescent girls’ substance use as well as their preferences and developmental needs for support that encourage sustained behaviour change throughout pregnancy and the postpartum period and that effectively address the influence of partners and friends on use. PMID:24405036
Jawad, Mohammed; Bakir, Ali; Ali, Mohammed; Grant, Aimee
Background. Despite the rise in prevalence of waterpipe tobacco smoking, it has received little legislative enforcement from governing bodies, especially in the area of health warning labels. Methods. Twenty regular waterpipe tobacco smokers from London took part in five focus groups discussing the impact of waterpipe tobacco pack health warnings on their attitudes towards waterpipe smoking. We presented them with existing and mock waterpipe tobacco products, designed to be compliant with current and future UK/EU legislation. Data were analysed using thematic analysis. Results. Participants felt packs were less attractive and health warnings were more impactful as health warnings increased in size and packaging became less branded. However, participants highlighted their lack of exposure to waterpipe tobacco pack health warnings due to the inherent nature of waterpipe smoking, that is, smoking in a café with the apparatus already prepacked by staff. Health warnings at the point of consumption had more reported impact than health warnings at the point of sale. Conclusions. Waterpipe tobacco pack health warnings are likely to be effective if compliant with existing laws and exposed to end-users. Legislations should be reviewed to extend health warning labels to waterpipe accessories, particularly the apparatus, and to waterpipe-serving premises. PMID:26273642
El-Shahawy, Omar; Sun, Ping; Tsai, Jennifer Yo-ka; Rohrbach, Louise Ann; Sussman, Steve
We examined the association between a general construct of wellness beliefs, sense of coherence, and a specific measure of tobacco-related beliefs, tobacco use myths, as predictors of two smoking -related outcome measures - next year smoking expectation and last 30-day smoking. Self-report questionnaires were administered to 710 adolescents attending California continuation high schools at baseline and at one-year follow-up between 2006 and 2008. Cross-sectionally, predictor and outcome measures were correlated. However, in longitudinal analyses, only tobacco use myths predicted change in outcome measures. We speculate that future smoking interventions among adolescents would achieve relatively efficacious outcomes by targeting specific health beliefs instead of global health beliefs. The study’s limitations are noted. Funding: National Institute on Drug Abuse and Tobacco Related Disease Research Program. PMID:25262653
Rostron, Brian L.; Chang, Cindy M.; van Bemmel, Dana M.; Xia, Yang; Blount, Benjamin C.
Background It has been suggested that smokeless tobacco users have high levels of exposure to nicotine and some toxic substances as measured by biomarker concentrations, but studies with nationally representative data have been limited. Methods We analyzed biomarkers of tobacco exposure for 23,684 adult participants from the National Health and Nutrition and Examination Survey (NHANES) from 1999-2012. The biomarkers analyzed were serum cotinine, urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), blood lead, blood cadmium, blood mercury, urinary arsenic, and urinary N-acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA). We calculated geometric mean concentrations for each biomarker by tobacco use category (exclusive smokeless tobacco use, exclusive cigarette smoking, dual cigarette and smokeless tobacco use, and non-cigarette and smokeless tobacco use) and geometric mean ratios adjusting for demographic factors. Results Exclusive smokeless tobacco users had higher geometric mean concentrations of cotinine (178.9 ng/mL, 95% CI = 145.5, 220.0) and NNAL (583.0 pg/mg creatinine, 95% CI = 445.2, 763.5) than exclusive cigarette smokers, (130.6 ng/mL, 95% CI = 122.3, 139.6 and 217.6 pg/mg creatinine, 95% CI = 193.0, 245.2, respectively). Smokeless tobacco users also had higher concentrations of blood lead compared with non-tobacco users (adjusted geometric mean ratio = 1.30, 95% CI = 1.21, 1.38). Differences in concentrations of cadmium, mercury, and CYMA between smokeless tobacco users and non-tobacco users were not observed. Based on limited sample sizes, NNAL concentrations for smokeless tobacco users appear to have declined from 2007-2008 (geometric mean = 1013.7 pg/mg creatinine, 95% CI = 738.9, 1390.8) to 2011-2012 (geometric mean = 325.7 pg/mg creatinine, 95% CI = 159.6, 664.9). Conclusions Smokeless tobacco users have higher observed levels of exposure to nicotine and carcinogenic tobacco-specific nitrosamines, as measured by cotinine and NNAL biomarker
Van Ryzin, Mark J; DeLay, Dawn; Dishion, Thomas J
Although substance use has traditionally been linked to peer deviance, a parallel literature has explored the influence of peer social status (being "well-liked"). This literature hypothesizes that adolescents with higher status will anticipate shifts in social norms and modify their behavior earlier and/or more substantially than lower-status students. As substance use becomes more socially acceptable during early-to-mid-adolescence, higher status youth are hypothesized to reflect this shift in norms by accelerating their use more rapidly than lower status youth. Although some evidence exists to support this hypothesis, it has never been evaluated in conjunction with the opposing hypothesis (i.e., that substance use contributes to elevated peer status). In this study, we evaluated reciprocal links between peer status and substance use (i.e., alcohol and tobacco) using 3years of data from 8 middle schools in the Pacific Northwest. Social network analysis enabled us to model standard network effects along with unique effects for the influence of the network on behavior (i.e., increased substance use as a result of being well-liked) and the influence of behavior on the network (i.e., increased status as a result of substance use). Our results indicated significant bidirectional effects for alcohol use but no significant effects for tobacco use. In other words, being well-liked significantly predicted alcohol use and vice versa, but these processes were not significant for tobacco use. Prevention efforts should consider the dynamics of peer status and peer norms in adolescence with the goal of preventing escalations in problem behavior that can compromise future adjustment.
Gilpin, Elizabeth A.; White, Martha M.; Messer, Karen; Pierce, John P.
Objectives. We investigated whether receptivity to tobacco advertising and promotions during young adolescence predicts young adult smoking 6 years later. Methods. Two longitudinal cohorts of adolescents drawn from the 1993 and 1996 versions of the California Tobacco Surveys were followed 3 and 6 years later. At baseline, adolescents were aged 12 to 15 years and were not established smokers. The outcome measure was established smoking at final follow-up. Receptivity to cigarette advertising and promotions was included in a multivariate logistic regression analysis along with demographic and other variables. Results. The rate of established smoking at follow-up was significantly greater among members of the 1993 through 1999 cohort (21.0%) than among members of the 1996 through 2002 cohort (15.6%). However, in both cohorts, having a favorite cigarette advertisement and owning or being willing to use a tobacco promotional item showed nearly identical adjusted odds of future adult smoking (1.46 and 1.84, respectively). Conclusions. Despite the success of tobacco control efforts in reducing youth smoking, tobacco marketing remains a potent influence on whether young adolescents become established smokers in young adulthood (18–21 years of age). PMID:17600271
Park, H K; Al Agili, D E; Bartolucci, A
A rapid rise in the number of tobacco users in Saudi Arabia has occurred in the past decade, particularly among the youth. This study identified socio-cultural determinants of tobacco use and explored possible approaches to prevent adolescents' tobacco use in Saudi Arabia. A cross-sectional survey was administered using a self-administered questionnaire for collecting information on risk and protective factors for tobacco use among middle school students. School selection was stratified by region, gender, and type (public or private). Of 1,186 7-9th grade students, 1,019 questionnaires were analyzed. Risk factors affecting tobacco use included all important others' perceptions; mother, sister, friend, teacher and important person's tobacco use; pressure to use tobacco from brother, sister, friend and important persons; easy access to tobacco and frequent skipping of classes. Protective factors for tobacco use included family's perception; friend, teacher and important person's tobacco use; parents' help; support from family, friends, and teachers; accessibility to tobacco; school performance and family income, father's education, and district of residence. The findings of this study show clear gender differences in social influences and attitudes towards tobacco use. Religious beliefs and access to tobacco products were significantly associated with attitudes towards tobacco use and future intention of use. Developing and implementing effective gender specific school-based tobacco prevention programs, strict reinforcement of tobacco control policies, and a focus on the overall social context of tobacco use are crucial for developing successful long-term tobacco prevention programs for adolescents.
Hodder, Rebecca Kate; Freund, Megan; Bowman, Jenny; Gillham, Karen; Dray, Julia; Wiggers, John
Objectives Research suggests that individual and environmental resilience protective factors may be associated with adolescent substance use; however, the associations between a broad range of such factors and use of various types of substances have not been examined. The study aimed to determine the association between a comprehensive range of adolescent individual and environmental resilience protective factors and measures of tobacco, alcohol and illicit substance use. Design Cross-sectional study. Setting 32 Australian secondary schools. Participants Grade 7–10 students (aged 11–17 years). Measures Data regarding 14 student individual and environmental resilience protective factors and seven substance use measures (tobacco, alcohol, marijuana, other illicit drug use) were obtained via an online self-report survey. Adjusted multivariate logistic regression analyses examined the association between all student resilience protective factors and seven substance use measures. Results Inverse univariate associations were found for 94 of 98 relationships examined (n=10 092). Multivariate analyses found: consistent inverse associations between 2 of 14 protective factors and all substance use measures (‘goals and aspirations’, ‘prosocial peers’); inverse associations between 4 protective factors with multiple substance use measures (‘home support’ (5 of 7), ‘school support’ (3 of 7), ‘self-awareness’ (2 of 7), ‘community meaningful participation’ (2 of 7)); positive associations between 2 resilience protective factors with multiple measures of substance use (‘community support’ (3 of 7), ‘peer caring relationships’ (5 of 7)) and 6 protective factors not to be associated with any substance use measure. Conclusions Despite individual relationships between the majority of resilience protective factors and substance use types, the protective benefit of such factors for adolescent substance use was limited to only a small number of
Bauman, K E; Foshee, V A; Ennett, S T; Pemberton, M; Hicks, K A; King, T S; Koch, G G
OBJECTIVES: This study examined a family-directed program's effectiveness in preventing adolescent tobacco and alcohol use in a general population. METHODS: Adolescents aged 12 to 14 years and their families were identified by random-digit dialing throughout the contiguous United States. After providing baseline data by telephone interviews, they were randomly allocated to receive or not receive a family-directed program featuring mailed booklets and telephone contacts by health educators. Follow-up telephone interviews were conducted 3 and 12 months after program completion. RESULTS: The findings suggested that smoking onset was reduced by 16.4% at 1 year, with a 25.0% reduction for non-Hispanic Whites but no statistically significant program effect for other races/ethnicities. There were no statistically significant program effects for smokeless tobacco or alcohol use onset. CONCLUSIONS: The family-directed program was associated with reduced smoking onset for non-Hispanic Whites, suggesting that it is worthy of further application, development, and evaluation. PMID:11291373
García-Cantó, Eliseo; Rodríguez García, Pedro Luis; Pérez-Soto, Juan José; López Villalba, Francisco José; Rosa-Guillamón, Andrés
This study looks at the relationship between tobacco consumption and the physical activity and fitness levels of adolescents. In a sample of 533 adolescents, both a questionnaire to obtain information regarding tobacco consumption and the International Physical Activity Questionnaire for information on physical activity were implemented; a battery of tests to assess physical fitness were also applied. Tobacco consumption was significantly higher in females (32.5%) than in males (25.7%). Levels of physical activity in both males and females were significantly associated with tobacco consumption (p<0.0005). Moreover, subjects who consumed tobacco showed lower overall averages in physical fitness tests than those who did not (4.26 vs. 5.77 in males and 4.54 vs. 6.71 in females). Tobacco consumption is therefore shown to be related to lower levels of physical activity and physical fitness in adolescents.
King, Keith A.; Merianos, Ashley L.; Vidourek, Rebecca A.
Background: Because marijuana is becoming more accessible and perceived norms of use are becoming increasingly more favorable, research is needed to understand characteristics of marijuana acquisition among adolescents. Purpose: The study purpose was to examine whether sources and locations where adolescent users obtain and use marijuana differed…
Holt, Colleen M.; Dowell, Richard C.
This study examined changes to speech production in adolescents with hearing impairment following a period of actor vocal training. In addition to vocal parameters, the study also investigated changes to psychosocial factors such as confidence, self-esteem, and anxiety. The group were adolescent users of cochlear implants (mean age at commencement…
Hall, Amanda K.; Mercado, Rebeccah; Anderson-Lewis, Charkarra; Darville, Gabrielle
Abstract Objective: Games for health, including digital videogames and gaming-based approaches, are increasingly being used in health promotion research and practice. Recently published research has shown that videogames have significant potential to promote healthy behaviors among youth and adolescents. Yet, there is a lack of available evidence-based resources to guide practitioners on the integration of games into tobacco prevention and smoking cessation interventions. To address this gap, expert researchers and game developers were interviewed to further define games for health, explore the current research, and provide recommendations for developing, evaluating, and promoting effective anti-tobacco games. Materials and Methods: Nationally recognized experts on game development, games for health, tobacco, and health behavior were asked to participate. A qualitative analysis of 25 in-depth individual interviews using a constant comparative approach for emerging themes was conducted. Results: Main themes that emerged from the data analysis included the following: (1) the current state of games for health research to facilitate health behavior change, (2) strategies for how to develop and evaluate games for quality and impact, and (3) recommendations for how to effectively design tobacco prevention and smoking cessation educational videogames that engage youth and adolescents. Conclusions: The synthesized findings identified through these expert interviews offer stakeholders strategies for how to incorporate games for health within their current and future work. Specific recommendations are presented for developers and researchers to consider when developing and evaluating videogames for tobacco prevention and smoking cessation targeted at youth and adolescents. PMID:26230046
Case, Kathleen R.; Cooper, Maria; Creamer, MeLisa; Mantey, Dale; Kelder, Steven; Grossman, Beth Toby
Background: Being a victim of bullying is associated with greater risk of youth substance use; however, research specifically examining whether tobacco use behaviors differ among adolescents who were bullied at school only, electronically only, or both at school and electronically is limited. Methods: We examined the associations between being a…
Dziuda-Gorzkowska, Maria R; Grzybowski, Andrzej; Nowacka, Ewa
The aim of the study was the assessment of the health status of adolescents exposed to tobacco smoke. The questionnaire and internal examination covered 202 of Lodz high school students. The tobacco smoke exposure was assessed by cotinine measurement in urine with the HPLC method. The results indicate intensive passive and active exposure to tobacco smoke among the examined adolescents, which was reflected in the cotinine levels in urine, 30-40 times higher in smokers than in the remaining subjects. The active smokers more frequently manifested problems of respiratory nad neurovegetative systems, however there were no differences in the subjective study results as well as in the frequency rate of using health care services by the active smokers and the remaining subjects.
Elmore, Kristen C; Scull, Tracy M; Kupersmidt, Janis B
Adolescents' media environment offers information about who uses substances and what happens as a result-how youth interpret these messages likely determines their impact on normative beliefs about alcohol and tobacco use. The Message Interpretation Processing (MIP) theory predicts that substance use norms are influenced by cognitions associated with the interpretation of media messages. This cross-sectional study examined whether high school adolescents' (n = 817, 48 % female, 64 % white) media-related cognitions (i.e., similarity, realism, desirability, identification) were related to their perceptions of substance use norms. Results revealed that adolescents' media-related cognitions explained a significant amount of variance in perceived social approval for and estimated prevalence of peer alcohol and tobacco use, above and beyond previous use and demographic covariates. Compared to prevalence norms, social approval norms were more closely related to adolescents' media-related cognitions. Results suggest that critical thinking about media messages can inhibit normative perceptions that are likely to increase adolescents' interest in alcohol and tobacco use.
Islam, Sheikh Mohammed Shariful; Mainuddin, A. K. M.; Bhuiyan, Faiz Ahmed; Chowdhury, Kamrun Nahar
Background: Tobacco use is an alarming public health problem worldwide and causes significant morbidity and mortality. In many developing countries tobacco use starts at a relative younger age. However, data on tobacco use among adolescents in Bangladesh is scarce. Objectives: The main objective of this study was to estimate the prevalence of tobacco use and its contributing factors among adolescents in Bangladesh. Materials and Methods: We used data from the Global Youth Tobacco Survey (GYTS) Bangladesh 2007 which was a school-based survey of 2,135 students aged 13-15 years in grades 7-10. Analysis: A two-stage cluster sample design was used to produce representative data for Bangladesh. At the first stage, schools were selected with probability proportional to enrollment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate. The GYTS sample design produced representative, independent, cross-sectional estimates for Bangladesh. Results: The overall prevalence of ever cigarette smokers in Bangladeshi students was about 9%, which was more than 3 times higher in boys compared to girls (15.8% versus 4.8%). Almost 4 in 10 students start smoking before the age of 10 in Bangladesh. In addition to current cigarette smoking, another 6% also reported to use other tobacco products currently. Nine in 10 current smokers reported that they had ever received help to stop smoking. More than 4 in 10 students were exposed to smoke from other people in public places. Among current smokers, 38.3% reported that they usually buy tobacco in a store and of which 97.8% reported that they were not refused cigarette purchase because of their age. Conclusion: Implementation and enforcement of tobacco control act is an urgent public health priority in Bangladesh. PMID:28032084
Croghan, Ivana T.; Severson, Herbert H.; Schroeder, Darrell R.; Hays, J. Taylor
Introduction: Long-term smokeless tobacco (ST) use is known to increase the risk for oropharyngeal cancer, heart attack, and stroke. Varenicline has recently been demonstrated to increase ST abstinence rates among Swedish snus users. We have conducted a pilot study to obtain preliminary evidence of efficacy of varenicline for the treatment of ST users in Midwestern United States. Methods: We conducted a randomized, placebo-controlled Phase II clinical trial to evaluate the potential efficacy of 12 weeks of varenicline for the treatment of ST users with an a priori decision rule that a 1-tailed p < .20 for the comparison of the primary endpoint was evidence to conclude that future studies were warranted. Subjects were followed for 6 months after randomization. Results: We randomized 76 subjects (38 varenicline and 38 placebo). Subjects were similar at baseline with a mean age of 41 years, and all were male. The biochemically confirmed point prevalence tobacco abstinence rates at end of treatment were 55.3% for varenicline and 42.1% for placebo (p = .126) and 47.4% and 31.6% (p = .080), respectively, at 6 months. Point prevalence ST abstinence rates at end of treatment for varenicline were 57.9% and 42.1% for placebo (p = .084) and 57.9% and 31.6% (p = .011), respectively, at 6 months. Varenicline was associated with significantly less craving compared with placebo. Varenicline was well tolerated with nausea and sleep disturbance being the most common side effects. Conclusions: Varenicline decreases craving and may be effective for increasing tobacco abstinence rates among ST users. Larger trials may be warranted to confirm these results. PMID:21504885
Hennessy, Emily A.; Tanner-Smith, Emily E.; Steinka-Fry, Katarzyna T.
This meta-analysis synthesizes studies of brief interventions (BIs) that targeted alcohol consumption and reported both alcohol and tobacco outcomes. It examines whether BIs reduce alcohol and tobacco use for adolescents and young adults among interventions that (1) directly targeted tobacco and alcohol use, or (2) did not target tobacco use but measured it as a secondary outcome. Multiple databases and grey literature sources were searched (1980–2012) resulting in the identification of 18 randomized or controlled quasi-experimental studies (5949 participants). Analyses were conducted using random effects inverse-variance weighted three-level models. BIs were associated with a significant reduction in alcohol consumption relative to control groups (ḡ = 0.11, 95% CI [0.04, 0.17]) but not with a significant decrease in tobacco use (ḡ = 0.07, 95% CI [−0.01, 0.16]). Directly addressing tobacco was not a significant moderator affecting tobacco use outcomes. Post-hoc exploratory analysis revealed potential questions to address with future research. PMID:26130030
Bava, Sunita; Jacobus, Joanna; Mahmood, Omar; Yang, Tony T.; Tapert, Susan F.
Background: Progressive myelination during adolescence implicates an increased vulnerability to neurotoxic substances and enduring neurocognitive consequences. This study examined the cognitive manifestations of altered white matter microstructure in chronic marijuana and alcohol-using (MJ + ALC) adolescents. Methods: Thirty-six MJ + ALC…
Hill, Danielle; Mrug, Sylvie
Background School-level characteristics are related to students’ substance use, but little research systematically examined multiple school characteristics in relation to different types of substance use across grade levels. Objectives This study examines multiple school-level characteristics as correlates of students’ tobacco, alcohol, marijuana, and combined substance use across three grade levels. Methods Students (N = 23,615) from 42 urban and suburban middle schools and 24 high schools in the U.S. reported on their tobacco, alcohol, and marijuana use. Students’ mean age was 14 years; 47% were male, 53% African American and 41% Caucasian. School-level data included poverty, racial composition, academic achievement, student-teacher ratio, absenteeism, and school size. Multilevel logistic and Poisson regressions tested associations between school-level predictors and adolescent substance use in middle school, early high school and late high school. Results School-level poverty, more ethnic minority students, low achievement, and higher absenteeism were related to alcohol, marijuana and combined substance use, particularly at lower grade levels. By contrast, cigarette smoking was more prevalent in more affluent high schools with more White students. After adjusting for other school characteristics, absenteeism emerged as the most consistent predictor of student substance use. Conclusions/Importance Interventions addressing absenteeism and truancy in middle and high schools may help prevent student substance use. Schools serving poor, urban, and mostly minority students may benefit from interventions targeting alcohol and marijuana use, whereas interventions focusing on tobacco use prevention may be more relevant for schools serving more affluent and predominantly White students. PMID:26584423
Plancherel, Bernard; Bolognini, Monique; Stephan, Philippe; Laget, Jacques; Chinet, Leonie; Bernard, Mathieu; Halfon, Olivier
A questionnaire investigating adolescents' opinions and experiences regarding marijuana use was administered to 163 adolescents and young adults (96 boys and 67 girls) aged 13 to 20 (mean age = 16.8, s.d. = 1.5). Items referred to marijuana and other substances' dangerousness, representations regarding the positive and negative consequences of…
Swart, Dehran; Panday, Saadhna; Reddy, S Priscilla; Bergström, Erik; de Vries, Hein
This paper explores adolescent preferences for the setting, timing, delivery format, provider and key elements of tobacco control programmes. The need for programme sensitivity towards urban/rural, gender and ethnic subgroups is also discussed. Schools were purposively selected from the Southern Cape-Karoo Region, South Africa. Twelve prevention and nine cessation focus group discussions were conducted with Grade 6-8 students and Grade 8-9 smokers and ex-smokers, respectively. Adolescents reported similar preferences for prevention and cessation programmes. Although they were unaware of smoking prevention or cessation programmes, they reported a willingness to participate in such programmes. Programmes should include school-based activities that are supported by out-of-school activities held over weekends and holidays. Non-judgemental and empathetic teachers and peers, as well as ex-smokers were preferred as programme providers. School-based participatory delivery formats should be supported by community-based mass media approaches. Programmes can be jointly presented to boys and girls of diverse ethnic backgrounds with some gender-sensitive sessions. Programme participation and sustainability would be enhanced if it were exciting, fun filled and integrated into their daily lives. School-based programmes must be embedded within comprehensive approaches that involve community- and policy-level interventions.
Petersen, Bjørn; Weed, Ethan; Sandmann, Pascale; Brattico, Elvira; Hansen, Mads; Sørensen, Stine Derdau; Vuust, Peter
Cochlear implants (CIs) are primarily designed to assist deaf individuals in perception of speech, although possibilities for music fruition have also been documented. Previous studies have indicated the existence of neural correlates of residual music skills in postlingually deaf adults and children. However, little is known about the behavioral and neural correlates of music perception in the new generation of prelingually deaf adolescents who grew up with CIs. With electroencephalography (EEG), we recorded the mismatch negativity (MMN) of the auditory event-related potential to changes in musical features in adolescent CI users and in normal-hearing (NH) age mates. EEG recordings and behavioral testing were carried out before (T1) and after (T2) a 2-week music training program for the CI users and in two sessions equally separated in time for NH controls. We found significant MMNs in adolescent CI users for deviations in timbre, intensity, and rhythm, indicating residual neural prerequisites for musical feature processing. By contrast, only one of the two pitch deviants elicited an MMN in CI users. This pitch discrimination deficit was supported by behavioral measures, in which CI users scored significantly below the NH level. Overall, MMN amplitudes were significantly smaller in CI users than in NH controls, suggesting poorer music discrimination ability. Despite compliance from the CI participants, we found no effect of the music training, likely resulting from the brevity of the program. This is the first study showing significant brain responses to musical feature changes in prelingually deaf adolescent CI users and their associations with behavioral measures, implying neural predispositions for at least some aspects of music processing. Future studies should test any beneficial effects of a longer lasting music intervention in adolescent CI users.
Petersen, Bjørn; Weed, Ethan; Sandmann, Pascale; Brattico, Elvira; Hansen, Mads; Sørensen, Stine Derdau; Vuust, Peter
Cochlear implants (CIs) are primarily designed to assist deaf individuals in perception of speech, although possibilities for music fruition have also been documented. Previous studies have indicated the existence of neural correlates of residual music skills in postlingually deaf adults and children. However, little is known about the behavioral and neural correlates of music perception in the new generation of prelingually deaf adolescents who grew up with CIs. With electroencephalography (EEG), we recorded the mismatch negativity (MMN) of the auditory event-related potential to changes in musical features in adolescent CI users and in normal-hearing (NH) age mates. EEG recordings and behavioral testing were carried out before (T1) and after (T2) a 2-week music training program for the CI users and in two sessions equally separated in time for NH controls. We found significant MMNs in adolescent CI users for deviations in timbre, intensity, and rhythm, indicating residual neural prerequisites for musical feature processing. By contrast, only one of the two pitch deviants elicited an MMN in CI users. This pitch discrimination deficit was supported by behavioral measures, in which CI users scored significantly below the NH level. Overall, MMN amplitudes were significantly smaller in CI users than in NH controls, suggesting poorer music discrimination ability. Despite compliance from the CI participants, we found no effect of the music training, likely resulting from the brevity of the program. This is the first study showing significant brain responses to musical feature changes in prelingually deaf adolescent CI users and their associations with behavioral measures, implying neural predispositions for at least some aspects of music processing. Future studies should test any beneficial effects of a longer lasting music intervention in adolescent CI users. PMID:25705185
Sweeting, Helen N; Bhaskar, Abita; Hunt, Kate
Background There is concern about the negative impact of modern consumer culture on young people's mental health, but very few studies have investigated associations with substance use. In those which have, positive associations have been attributed to attempts to satisfy the unmet needs of more materialistic individuals. Objectives This study examines associations between different dimensions of consumerism and tobacco and alcohol use among Scottish early adolescents. Design Cross-sectional study. Setting and participants 2937 (92% of those eligible) secondary school pupils (ages 12–14) completed questionnaires in examination conditions. Analyses were restricted to those with complete data on all relevant variables (N=2736 smoking; N=2737 drinking). Measures Dependent variables comprised ever smoking and current drinking. Measures of consumerism comprised number of ‘premium’ (range 0–7) and ‘standard’ (range 0–5) material possessions and three Consumer Involvement subscales, ‘dissatisfaction’, ‘consumer orientation’ and ‘brand awareness’ (each range 3–12). Analyses also included school-year group and family affluence. Results Ever smoking and current drinking were both more prevalent among adolescents with more ‘premium’ and ‘standard’ material possessions, greater consumer ‘dissatisfaction’ and ‘brand awareness’ (mutually adjusted analyses including school-year group and family affluence). The strongest relationships occurred for ‘brand awareness’: for each unit increase in ‘brand awareness’ the ORs (95% CI) of ever smoking were 1.17 (1.08 to 1.26) and 1.23 (1.14 to 1.33) in males and females, respectively; and those for drinking were 1.15 (1.08 to 1.23) and 1.21 (1.13 to 1.30). ‘Brand awareness’ had an equal or stronger relationship with both smoking and drinking than did family affluence. Conclusions These results suggest aassociations between consumerism and both smoking and drinking might arise because
Redner, Ryan; White, Thomas J; Harder, Valerie S; Higgins, Stephen T
Smoking prevalence is unevenly distributed in the U.S. population, with those with mental illness, other substance use disorders, and lower socioeconomic status being especially vulnerable. Less research has been conducted on the association between these same vulnerabilities and smokeless tobacco (ST) use. The present study examined cigarette and ST use among adolescents and adults who met diagnostic criteria for major depressive disorder in the National Survey on Drug Use and Health (NSDUH). Utilizing the most recent (2011) NSDUH, we compared odds for current cigarette smoking and ST use among adolescents and adults meeting criteria for past-year major depressive disorder to the general population, after adjusting for potential confounding influences of sociodemographic and other substance use characteristics. Analyses were conducted to examine sex as a moderator of the relation between major depressive disorder and tobacco use. Odds for current cigarette smoking among those classified with major depressive disorder were increased among adolescents (OR = 1.33, 95% CI [1.05, 1.69], p = .021) and adults (OR = 1.70, 95% CI [1.47, 1.97], p < .0005), and odds for current ST use did not differ among adolescents (OR = 0.90, 95% CI [0.54, 1.49], p = .678) and were lower among adults (OR = 0.68, 95% CI [0.51, 0.91], p = .010). Sex was not a significant moderator in adolescents or adults. Major depressive disorder is associated with increased risk for smoking but not ST use among adolescents and adults further demonstrating heterogeneity in predictors of vulnerability to use of different tobacco products.
Kim, Jieun E; Kim, Geon Ha; Hwang, Jaeuk; Kim, Jung Yoon; Renshaw, Perry F; Yurgelun-Todd, Deborah A; Kim, Binna; Kang, Ilhyang; Jeon, Saerom; Ma, Jiyoung; Lyoo, In Kyoon; Yoon, Sujung
The adolescent brain, with ongoing prefrontal maturation, may be more vulnerable to drug use-related neurotoxic changes as compared to the adult brain. We investigated whether the use of methamphetamine (MA), a highly addictive psychostimulant, during adolescence affect metabolic and cognitive functions of the anterior cingulate cortex (ACC). In adolescent MA users (n = 44) and healthy adolescents (n = 53), the levels of N-acetyl aspartate (NAA), a neuronal marker, were examined in the ACC using proton magnetic resonance spectroscopy. The Stroop color-word task was used to assess Stroop interference, which may reflect cognitive functions of behavior monitoring and response selection that are mediated by the ACC. Adolescent MA users had lower NAA levels in the ACC (t = -2.88, P = 0.005) and relatively higher interference scores (t = 2.03, P = 0.045) than healthy adolescents. Moreover, there were significant relationships between lower NAA levels in the ACC and worse interference scores in adolescent MA users (r = -0.61, P < 0.001). Interestingly, early onset of MA use, as compared to late onset, was related to both lower NAA levels in the ACC (t = -2.24, P = 0.03) as well as lower performance on interference measure of the Stroop color-word task (t = 2.25, P = 0.03). The current findings suggest that metabolic dysfunction in the ACC and its related cognitive impairment may play an important role in adolescent-onset addiction, particularly during early adolescence.
Lee, Youn Ok; Bahreinifar, Sareh; Ling, Pamela M.
Objective: To examine differences in tobacco-related attitudes and hookah and cigarette use among college and noncollege young adults. Participants: Time-location samples of young adult bar patrons in San Diego, California ("N" = 2,243), Tulsa ("N" = 2,095) and Oklahoma City ("N" = 2,200), Oklahoma, Albuquerque…
Moon, Sung Seek; Rao, Uma
In this article, we present the effects of three hypothesized protective factors: social activities, school-related activities, and anti-substance use media messages on adolescent tobacco and alcohol use. Data were drawn from the "Monitoring the Future" (MTF) research project, which was conducted by the Institute for Social Research at the University of Michigan. The sample included 2,551 twelfth-grade students. The results of the structural equation model showed that exposure to media anti-drug messages had an indirect negative effect on tobacco and alcohol use through school-related activity and social activity. The results suggest that comprehensive ecological interventions encompassing media, family, and school can increase on the preventive effects of adolescent's substance use.
McQueen, Amy; Caburnay, Charlene A.; Boyum, Sonia; Sanders Thompson, Vetta L.; Kaphingst, Kimberly A.; Kreuter, Matthew W.
Introduction Tobacco quitlines are critical components of comprehensive tobacco control programs. However, use of the US National Tobacco Quitline (1-800-QUIT-NOW) is low. Promoting quitlines on cigarette warning labels may increase call volume and smoking cessation rates but only if smokers are aware of, and receptive to, quitline services. Methods We conducted qualitative interviews with a diverse subset (n = 159) of adolescent (14–17 y) and adult (≥18 y) participants of a larger quantitative survey about graphic cigarette warning labels (N = 1,590). A convenience sample was recruited from schools and community organizations in 6 states. Interviews lasted 30 to 45 minutes and included questions to assess basic knowledge and perceptions of the quitline number printed on the warning labels. Data were analyzed using content analysis. Results Four themes were identified: available services, caller characteristics, quitline service provider characteristics, and logistics. Participants were generally knowledgeable about quitline services, including the provision of telephone-based counseling. However, some adolescents believed that quitlines provide referrals to “rehab.” Quitline callers are perceived as highly motivated — even desperate — to quit. Few smokers were interested in calling the quitline, but some indicated that they might call if they were unable to quit independently. It was generally recognized that quitline services are or should be free, confidential, and operated by governmental or nonprofit agencies, possibly using tobacco settlement funds. Conclusion Future marketing efforts should raise awareness of the nature and benefits of quitline services to increase use of these services and, consequently, reduce tobacco use, improve public health, and reduce tobacco-related health disparities. PMID:26292062
Inglés, Cándido J; Torregrosa, María S; Rodríguez-Marín, Jesús; García del Castillo, José A; Gázquez, José J; García-Fernández, José M; Delgado, Beatriz
The aim of the present study was to analyze: (a) the relationship between alcohol and tobacco use and academic performance, and (b) the predictive role of psycho-educational factors and alcohol and tobacco abuse on academic performance in a sample of 352 Spanish adolescents from grades 8 to 10 of Compulsory Secondary Education. The Self-Description Questionnaire-II, the Sydney Attribution Scale, and the Achievement Goal Tendencies Questionnaire were administered in order to analyze cognitive-motivational variables. Alcohol and tobacco abuse, sex, and grade retention were also measured using self-reported questions. Academic performance was measured by school records. Frequency analyses and logistic regression analyses were used. Frequency analyses revealed that students who abuse of tobacco and alcohol show a higher rate of poor academic performance. Logistic regression analyses showed that health behaviours, and educational and cognitive-motivational variables exert a different effect on academic performance depending on the academic area analyzed. These results point out that not only academic, but also health variables should be address to improve academic performance in adolescence.
Ray, Kimberly L.; Hines, Christina S.; Li, Karl; Dawes, Michael A.; Mathias, Charles W.; Dougherty, Donald M.; Laird, Angela R.
Background. Adolescent marijuana use is associated with structural and functional differences in forebrain regions while performing memory and attention tasks. In the present study, we investigated neural processing in adolescent marijuana users experiencing rewards and losses. Fourteen adolescents with frequent marijuana use (>5 uses per week) and 14 nonuser controls performed a computer task where they were required to guess the outcome of a simulated coin flip while undergoing magnetic resonance imaging. Results. Across all participants, “Wins” and “Losses” were associated with activations including cingulate, middle frontal, superior frontal, and inferior frontal gyri and declive activations. Relative to controls, users had greater activity in the middle and inferior frontal gyri, caudate, and claustrum during “Wins” and greater activity in the anterior and posterior cingulate, middle frontal gyrus, insula, claustrum, and declive during “Losses.” Effective connectivity analyses revealed similar overall network interactions among these regions for users and controls during both “Wins” and “Losses.” However, users and controls had significantly different causal interactions for 10 out of 28 individual paths during the “Losses” condition. Conclusions. Collectively, these results indicate adolescent marijuana users have enhanced neural responses to simulated monetary rewards and losses and relatively subtle differences in effective connectivity. PMID:25692068
Weichold, Karina; Tomasik, Martin J.; Silbereisen, Rainer K.; Spaeth, Michael
In this study, the effectiveness of a life skills program to impede tobacco use in early adolescence was scrutinized. The focus was on the mediating role of yielding to peer pressure. The universal school-based life skills program IPSY (Information + Psychosocial Competence = Protection) against adolescent substance use was implemented over 3…
Arbour-Nicitopoulos, Kelly P.
The study aims were to examine (i) adolescents' attitudes towards family members who use a wheelchair in relation to other health problems and conditions, and (ii) the association between perceived wheelchair stigma and socio-demographic factors. Data were based on surveys from 2790 seventh to 12th grade students derived from the 2007 cycle of the…
Whitt, Ahmed; Garland, Eric L; Howard, Matthew O
Although helium-related fatalities and concerns about potentially harmful effects of helium use have increased in recent years, virtually nothing is known about the epidemiology of helium inhalation in adolescents. This exploratory investigation examined the prevalence and correlates of helium inhalation in a large sample of at-risk youth. Study participants were 723 Missouri adolescents (M age = 15.5, SD = 1.2) in residential treatment for delinquent behavior. More than one-in-nine (N = 81, 11.5%) adolescents had inhaled helium with the intention of getting high, and one-third (N = 27, 34.2%) of helium users reported they actually did get high when they inhaled helium. Helium users were significantly more likely to be Caucasian, to live in rural/small town areas, and to have histories of mental illness, auditory hallucinations, and alcohol and marijuana use than nonusers. Helium users also reported significantly more current psychiatric distress, suicidality, traumatic life experiences, and antisocial attitudes, traits, and behaviors than nonusers. Helium inhalation was prevalent in this sample and many such users reported getting high while using helium. Helium users had psychosocial profiles similar to those of volatile solvent users, suggesting that they may be at substantial risk for a variety of adverse health outcomes.
Andreou, Eleni; Svoli, Hionia
This study examined how internet users' psychological characteristics, amount of internet use and demographic factors contribute to particular dimensions of internet addiction. The sample consisted of 384 adolescents, ranging in age from 15 to 18 years. Participants were asked to complete the Internet Addiction Test (IAT), measures of Locus of…
Abreu-Villaça, Yael; Correa-Santos, Monique; Dutra-Tavares, Ana C; Paes-Branco, Danielle; Nunes-Freitas, Andre; Manhães, Alex C; Filgueiras, Cláudio C; Ribeiro-Carvalho, Anderson
The tobacco industry has gradually decreased nicotine content in cigarette smoke but the impact of this reduction on health is still controversial. Since the central cholinergic system is the primary site of action of nicotine, here, we investigated the effects of exposure of adolescent mice to tobacco smoke containing either high or low levels of nicotine on the central cholinergic system and the effects associated with cessation of exposure. From postnatal day (PN) 30 to 45, male and female Swiss mice were exposed to tobacco smoke (whole body exposure, 8h/day, 7 days/week) generated from 2R1F (HighNic group: 1.74mg nicotine/cigarette) or 4A1 (LowNic group: 0.14mg nicotine/cigarette) research cigarettes, whereas control mice were exposed to ambient air. Cholinergic biomarkers were assessed in the cerebral cortex and midbrain by the end of exposure (PN45), at short- (PN50) and long-term (PN75) deprivation. In the cortex, nicotinic cholinergic receptor upregulation was observed with either type of cigarette. In the midbrain, upregulation was detected only in HighNic mice and remained significant in females at short-term deprivation. The high-affinity choline transporter was reduced in the cortex: of HighNic mice by the end of exposure; of both HighNic and LowNic females at short-term deprivation; of LowNic mice at long-term deprivation. These decrements were separable from effects on choline acetyltransferase and acetylcholinesterase activities, suggesting cholinergic synaptic impairment. Here, we demonstrated central cholinergic alterations in an animal model of tobacco smoke exposure during adolescence. This system was sensitive even to tobacco smoke with very low nicotine content.
Bacio, Guadalupe A.; Estrada, Yannine; Huang, Shi; Martínez, Marcos; Sardinas, Krystal; Prado, Guillermo
The purpose of this cross-sectional study was to test the transactional relationships of risk and protective factors that influence initiation of alcohol, tobacco, and drug use among Hispanic youth. Ecodevelopmental theory was used to identify factors at multiple ecological levels with a focus on four school-level characteristics (i.e. school socioeconomic status, school climate, school acculturation, and school ethnic composition). A sample of 741 Hispanic adolescents (M age =13.9, SD =.67) and their caregivers were recruited from 18 participating middle schools in Miami-Dade County, FL. Structural equation modeling was used to test the hypothesized ecodevelopmental model of early substance use, accounting for school clustering effects. Results provided strong support for the model (CFI = .95; RMSEA =.03). School SES was indirectly related to the likelihood of starting to use substances through perceived peer use norms (β =.03, p <.02). Similarly, school climate had an indirect effect on substance use initiation through family functioning and perceptions of peer use norms (β = −.03, p < .01). Neither school ethnic composition nor school acculturation had indirect effects on initiation of substance use. Results highlight the importance of the interplay of risk and protective factors at multiple ecological levels that impact early substance use initiation. Further, findings underscore the key role of school level characteristics on initiation of substance use and present opportunities for intervention. PMID:26054814
Milam, AJ; Furr-Holden, CDM; Bradshaw, CP; Webster, DW; Cooley-Strickland, MC; Leaf, PJ
This study examined the association between the count of alcohol outlets around children's homes and opportunities to use alcohol, tobacco, and other drugs (ATOD) during pre-adolescence. Data were collected in 2007 from 394 Baltimore City children aged 8-13 (86% African American). Participants' residential address and alcohol outlet data were geocoded with quarter mile (i.e., walking distance) buffers placed around each participant's home to determine the number of outlets within walking distance. The unadjusted logistic regression models revealed that each unit increase in the number of alcohol outlets was associated with a 14% increase in the likelihood of children seeing people selling drugs (OR=1.14, p=.04) and a 15% increase in the likelihood of seeing people smoking marijuana (OR=1.15, p<.01). After adjusting for neighborhood physical disorder, the relationship between alcohol outlets and seeing people selling drugs and seeing people smoking marijuana was fully attenuated. These results suggest that alcohol outlets are one aspect of the larger environmental context that is related to ATOD exposure in children. Future studies should examine the complex relationship between neighborhood physical disorder and the presence of alcohol outlets. PMID:25125766
Apostolou, Andria; Garcia-Esquinas, Esther; Fadrowski, Jeffrey J.; McLain, RN, Pat; Weaver, Virginia M.
Objectives. We evaluated the relationship between secondhand tobacco smoke (SHS) exposure and blood lead levels in US children and adolescents. Methods. We analyzed data from 6830 participants aged 3–19 years in the National Health and Nutrition Examination Survey (1999–2004) who were not active smokers and for whom SHS exposure information and blood lead measurements were available. Results. After multivariable adjustment, participants in the highest quartile of serum cotinine (≥ 0.44 μg/L) had 28% (95% confidence interval = 21%, 36%) higher blood lead levels than had those in the lowest quartile (< 0.03 μg/L). Similarly, blood lead levels were 14% and 24% higher in children who lived with 1 or with 2 or more smokers, respectively, than they were in children living with no smokers. Among participants for whom lead dust information was available, the associations between SHS and blood lead levels were similar before and after adjustment for lead dust concentrations. Conclusions. SHS may contribute to increased blood lead levels in US children. Lead dust does not appear to mediate this association, suggesting inhalation as a major pathway of exposure. Eliminating SHS exposure could reduce lead exposure in children. PMID:21852639
Kurtul, Naciye; Gökpınar, Engin
Maraş powder (MP), a different type of smokeless tobacco (ST) and prepared from a tobacco of species Nicotiana rustica Linn, is widely used in Turkey. We aimed to investigate the effects of MP on salivary total sialic acid (TSA) and malondialdehyde (MDA) levels and to compare these parameters in smokers and MP users (MPUs). The salivary TSA and MDA concentrations were significantly higher in the smokers and MPU than those of control subjects and also in MPU than that of smokers. We have also observed that as the number of cigarettes consumed and MP amount increases, TSA and MDA levels increase too. In smokers, MDA values were significantly correlated with the number of cigarettes smoked and the duration of smoking. In MPU, both MDA and TSA levels were significantly correlated with the duration of MP use and the amount of daily consumed MP. We have concluded increased salivary TSA and MDA levels associated in MPU and smokers. Results can help to evaluate harmful effects of these habits. It is important to point out that bigger change in the measured parameters has been observed for MP use. This observation may be an important indication of harmful effects of ST use as MP. PMID:22577253
Carver, Vivien; Reinert, Bonita; Range, Lillian M.
To examine cumulative impact of anti-smoking messages, 300+ sixth, seventh, and eighth graders at three southern, private schools completed the Youth Tobacco Survey during both fall and spring, 2001-2002. One school had tobacco lessons plus health-promotion teams, the other tobacco lessons, and the third classes as usual. In attitudes and…
Jacobus, Joanna; Squeglia, Lindsay M; Meruelo, Alejandro D; Castro, Norma; Brumback, Ty; Giedd, Jay N; Tapert, Susan F
Studies suggest marijuana impacts gray and white matter neural tissue development, however few prospective studies have determined the relationship between cortical thickness and cannabis use spanning adolescence to young adulthood. This study aimed to understand how heavy marijuana use influences cortical thickness trajectories across adolescence. Subjects were adolescents with heavy marijuana use and concomitant alcohol use (MJ+ALC, n=30) and controls (CON, n=38) with limited substance use histories. Participants underwent magnetic resonance imaging and comprehensive substance use assessment at three independent time points. Repeated measures analysis of covariance was used to look at main effects of group, time, and Group × Time interactions on cortical thickness. MJ+ALC showed thicker cortical estimates across the brain (23 regions), particularly in frontal and parietal lobes (ps<.05). More cumulative marijuana use was associated with increased thickness estimates by 3-year follow-up (ps<.05). Heavy marijuana use during adolescence and into young adulthood may be associated with altered neural tissue development and interference with neuromaturation that can have neurobehavioral consequences. Continued follow-up of adolescent marijuana users will help understand ongoing neural changes that are associated with development of problematic use into adulthood, as well as potential for neural recovery with cessation of use.
Barrientos-Gutiérrez, Tonatiuh; Barrientos-Gutiérrez, Inti; Reynales-Shigematsu, Luz Myriam; Thrasher, James F; Lazcano-Ponce, Eduardo
Exposure to tobacco advertisement is associated with smoking initiation among the youth, its elimination is a key objective to effectively curb the tobacco epidemic. Historically, the tobacco industry has pioneered the use of new communication technologies to keep and expand their market. Nowadays, Internet and video games have transcended the entertainment sphere, becoming significant media for massive communication and providing new opportunities for advertisement. The present essay reviews the existing literature on tobacco presence in the Internet and video games to define research and policy tasks required to develop effective means for tobacco advertisement regulation and control.
TERZIC SUPIC, Zorica; SANTRIC MILICEVIC, Milena; SBUTEGA, Isidora; VASIC, Vladimir
Background Adolescence is transitional stage of physical and mental human development occuring between childhood and adult life. Social interactions and environmental factors together are important predictors of adolescent cannabis use. This study aimed to examine the relationship between the social determinants and adolescents behavior with cannabis consumption. Methods: A cross sectional study as part of the European School Survey Project on Alcohol and other Drugs was conducted among 6.150 adolescents aged 16 years in three regions of Serbia, and three types of schools (gymnasium, vocational – professional, and vocational – handicraft) during May – June 2008. A multivariate logistic regression analysis was carried out to obtain adjusted odds ratios with 95% confidence intervals in which the dependent variable was cannabis consumption non-user and user. Results: Among 6.7% of adolescents who had tried cannabis at least one in their lives, boys were more involved in cannabis use than girls, especially boys from gymnasium school. Well off family, lower education of mother, worse relations with parents were significantly associated with cannabis use (P < 0.05). Behaviors like skipping from schools, frequent evening outs, and playing on slot machines were also related to cannabis use (P < 0.05). Conclusions: The study confirmed the importance of family relationship development. Drug use preventive programmes should include building interpersonal trust in a family lifecycle and school culture. PMID:23641402
Hodder, Rebecca Kate; Freund, Megan; Wolfenden, Luke; Bowman, Jenny; Gillham, Karen; Dray, Julia; Wiggers, John
Introduction Tobacco, alcohol and illicit drug use contribute significantly to global rates of morbidity and mortality. Despite evidence suggesting interventions designed to increase adolescent resilience may represent a means of reducing adolescent substance use, and schools providing a key opportunity to implement such interventions, existing systematic reviews assessing the effectiveness of school-based interventions targeting adolescent substance use have not examined this potential. Methods and analysis The aim of the systematic review is to determine whether universal interventions focused on enhancing the resilience of adolescents are effective in reducing adolescent substance use. Eligible studies will: include participants 5–18 years of age; report tobacco use, alcohol consumption or illicit drug use as outcomes; and implement a school-based intervention designed to promote internal (eg, self-esteem) and external (eg, school connectedness) resilience factors. Eligible study designs include randomised controlled trials, cluster randomised controlled trials, staggered enrolment trials, stepped wedged trials, quasi-randomised trials, quasi-experimental trials, time series/interrupted time-series trials, preference trials, regression discontinuity trials and natural experiment studies with a parallel control group. A search strategy including criteria for participants, study design, outcome, setting and intervention will be implemented in various electronic databases and information sources. Two reviewers will independently screen studies to assess eligibility, as well as extract data from, and assess risk of bias of included studies. A third reviewer will resolve any discrepancies. Attempts will be made to quantify trial effects by meta-analysis. Binary outcomes will be pooled and effect size reported using ORs. For continuous data, effect size of trials will be reported using a mean difference where trial outcomes report the same outcome using a
An NCI Cancer Currents blog post on a recent study that suggest adolescents are not just using e-cigarettes as a substitute for conventional cigarettes but that e-cigarettes are attracting new users to tobacco products.
This paper provides a review of the last two and a half decades of research in adolescent and young-adult tobacco use cessation. A total of 66 tobacco cessation intervention studies – targeted or population – are reviewed. In addition, an exhaustive review is completed of adolescent self-initiated tobacco use cessation, involving 17 prospective survey studies. Average reach and retention across the intervention studies was 61% and 78%, respectively, and was higher when whole natural units were treated (e.g., classrooms), than when units created specifically for the program were treated (e.g., school-based clinics). The mean quit-rate at a three to 12-month average follow-up among the program conditions was 12%, compared to approximately 7% across control groups. A comparison of intervention theories revealed that motivation enhancement (19%) and contingency-based reinforcement (16%) programs showed higher quit-rates than the overall intervention cessation mean. Regarding modalities (channels) of change, classroom-based programs showed the highest quit rates (17%). Computer-based (expert system) programs also showed promise (13% quit-rate), as did school-based clinics (12%). There was a fair amount of missing data and wide variation on how data points were measured in the programs' evaluations. Also, there were relatively few direct comparisons of program and control groups. Thus, it would be difficult to conduct a formal meta-analysis on the cessation programs. Still, these data suggest that use of adolescent tobacco use cessation interventions double quit rates on the average. In the 17 self-initiated quitting survey studies, key predictors of quitting were living in a social milieu that is composed of fewer smokers, less pharmacological or psychological dependence on smoking, anti-tobacco beliefs (e.g., that society should step in to place controls on smoking) and feeling relatively hopeful about life. Key variables relevant to the quitting process may
This paper provides a review of the last two and a half decades of research in adolescent and young-adult tobacco use cessation. A total of 66 tobacco cessation intervention studies – targeted or population – are reviewed. In addition, an exhaustive review is completed of adolescent self-initiated tobacco use cessation, involving 17 prospective survey studies. Average reach and retention across the intervention studies was 61% and 78%, respectively, and was higher when whole natural units were treated (e.g., classrooms), than when units created specifically for the program were treated (e.g., school-based clinics). The mean quit-rate at a three to 12-month average follow-up among the program conditions was 12%, compared to approximately 7% across control groups. A comparison of intervention theories revealed that motivation enhancement (19%) and contingency-based reinforcement (16%) programs showed higher quit-rates than the overall intervention cessation mean. Regarding modalities (channels) of change, classroom-based programs showed the highest quit rates (17%). Computer-based (expert system) programs also showed promise (13% quit-rate), as did school-based clinics (12%). There was a fair amount of missing data and wide variation on how data points were measured in the programs' evaluations. Also, there were relatively few direct comparisons of program and control groups. Thus, it would be difficult to conduct a formal meta-analysis on the cessation programs. Still, these data suggest that use of adolescent tobacco use cessation interventions double quit rates on the average. In the 17 self-initiated quitting survey studies, key predictors of quitting were living in a social milieu that is composed of fewer smokers, less pharmacological or psychological dependence on smoking, anti-tobacco beliefs (e.g., that society should step in to place controls on smoking) and feeling relatively hopeful about life. Key variables relevant to the quitting process may
Halperin, Abigail C.; McAfee, Tim A.; Jack, Lisa M.; Catz, Sheryl; McClure, Jennifer B.; Deprey, Mona; Richards, Julie; Zbikowski, Susan; Swan, Gary E.
This paper examines reported symptoms, nonsmoking rates, and medication use among 1018 smokers using varenicline in a randomized trial comparing three forms of behavioral support for smoking cessation (phone, web, or phone + web). One month after beginning varenicline, 168 people (17%) had discontinued the medication. Most (53%) quit due to side-effects and other symptoms. The most common side-effect among all users was nausea (reported by 57% of users). At one month post medication initiation, those not taking varenicline were more likely to report smoking than those who continued the medication (57% vs. 16%, p<.001). Women reported more symptoms but did not discontinue medication at higher rates. Participants who received any telephone counseling (n=681) were less likely to discontinue their medication than those with web support only (15% vs. 21%, p<.01). Counseling may improve tolerance of this medication and reduce the rate of discontinuation due to side-effects. (149 words) PMID:19004600
Chen, Wei J.; Ting, Te-Tien; Chang, Chao-Ming; Liu, Ying-Chun; Chen, Chuan-Yu
The popularity of ketamine for recreational use among young people began to increase, particularly in Asia, in 2000. To gain more knowledge about the use of ketamine among high risk individuals, a respondent-driven sampling (RDS) was implemented among regular alcohol and tobacco users in the Taipei metropolitan area from 2007 to 2010. The sampling was initiated in three different settings (i.e., two in the community and one in a clinic) to recruit seed individuals. Each participant was asked to refer one to five friends known to be regular tobacco smokers and alcohol drinkers to participate in the present study. Incentives were offered differentially upon the completion of an interview and successful referral. Information pertaining to drug use experience was collected by an audio computer-assisted self-interview instrument. Software built for RDS analyses was used for data analyses. Of the 1,115 subjects recruited, about 11.7% of the RDS respondents reported ever having used ketamine. Positive expectancy of ketamine use was positively associated with ketamine use; in contrast, negative expectancy inversely associated with ketamine use. Decision-making characteristics as measured on the Iowa Gambling Task using reinforcement learning models revealed that ketamine users learned less from the most recent event than both tobacco- and drug-naïve controls and regular tobacco and alcohol users. These findings about ketamine use among young people have implications for its prevention and intervention. PMID:25264412
Carpenter, Kelly M.; Cohn, Leslie G.; Glynn, Lisa H.; Stoner, Susan A.
One fifth of Americans smoke; many have no plans to quit. Motivational Interviewing (MI) is an effective approach to intervention with precontemplative smokers, yet a substantial number of healthcare practitioners lack training in this approach. Two interactive online tutorials were developed to teach practitioners to deliver brief tobacco cessation interventions grounded in the MI approach. The tutorials emphasized the unique aspects of working with precontemplative smokers, incorporating audio and video examples of best practices, interactive exercises, targeted feedback, and practice opportunities. One hundred and fifty-two healthcare providers-in-training were randomly assigned to use the online tutorials or to read training material that was matched for content. A virtual standardized patient evaluation was given before and after the training. Both groups improved their scores from pre- to posttest; however, the tutorial group scored significantly better than the reading group at posttest. The results of this study demonstrate the promise of interactive online tutorials as an efficient and effective way to deliver clinical education. PMID:22096413
Pinkleton, Bruce E; Weintraub Austin, Erica; Cohen, Marilyn; Miller, Autumn; Fitzgerald, Erin
Researchers used a quasi-experiment (N = 723) conducted in the field and using both pretests and posttests to carry out a theory-based evaluation of the effectiveness of a media literacy curriculum implemented in Washington state. Results showed that reflective thinking concerning media message about tobacco increased for all media literacy participants, whether or not they had used tobacco previously. Changes in reflective thinking affected a range of decision-making indicators. Lesson participants who had not used tobacco demonstrated greater change at earlier stages of decision making in ways that suggested a greater understanding of the persuasive techniques used by tobacco manufacturers, on indicators such as perceived realism, desirability, and similarity. Lesson participants who had tried tobacco demonstrated greater change at later stages of decision making on indicators such as perceived peer norms for tobacco use, identification with tobacco-related portrayals, and expectancies for tobacco use. All participants also showed increases in their ability and motivations to resist smoking-related influences. Overall, the results suggest that media literacy has important and somewhat different effects on those who have and those who have not experimented with tobacco use. The results also show the importance of measuring cognitive and affective indicators of decision making that may change gradually as participants gain experience putting lessons learned into action.
Horner, Pilar; Grogan-Kaylor, Andy; Delva, Jorge; Bares, Cristina B; Andrade, Fernando; Castillo, Marcela
Research on adolescent use of substances has long sought to understand the family factors that may be associated with use of different substances such as alcohol, tobacco, and marijuana. However, scant attention has been focused on these questions in Latin American contexts, despite growing concerns about substance use among Latin American youth. Using data from a sample of 866 Chilean youth, we examined the relationship of family and neighborhood factors with youth substance abuse. We found that in a Latin American context, access to substances is an important predictor of use, but that neighborhood effects differ for marijuana use as opposed to cigarettes or alcohol. Age of youth, family and peer relationships, and gender all play significant roles in substance use. The study findings provide additional evidence that the use of substances is complex, whereby individual, family, and community influences must be considered jointly to prevent or reduce substance use among adolescents. PMID:22224067
Horner, Pilar; Grogan-Kaylor, Andy; Delva, Jorge; Bares, Cristina B; Andrade, Fernando; Castillo, Marcela
Research on adolescent use of substances has long sought to understand the family factors that may be associated with use of different substances such as alcohol, tobacco and marijuana. However, scant attention has been focused on these questions in Latin American contexts, despite growing concerns about substance use among Latin American youth. Using data from a sample of 866 Chilean youth, we examined the relationship of family and neighborhood factors with youth substance abuse. We found that in a Latin American context access to substances is an important predictor of use, but that neighborhood effects differ for marijuana use as opposed to cigarettes or alcohol. Age of youth, family and peer relationships, and gender all play significant roles of substance use.The study findings provide additional evidence that the use of substances is complex whereby individual, family, and community influences must be considered jointly to prevent or reduce substance use among adolescents.
Tager, Ira B
Cigarette smoking still is quite common in many parts of the world. In parallel, exposure to second-hand smoke continues to be common despite declines in smoking in developed countries and despite evidence of serious health effects in infants and children. This paper focuses on the effects of second-hand and direct exposure (personal smoking) on the respiratory health of adolescents, in particular effects on the occurrence of asthma and on lung function. Published data indicate that, in addition to whatever effects direct and postnatal second-hand tobacco smoke exposure have on the occurrence of asthma and impaired levels and growth of lung function in adolescents, there is an underlying alteration in the prenatal and early postnatal development of the structural and mechanical characteristics of the lung that contribute substantially to these deficits. These developmental effects may be important contributors to the future risks for impaired pulmonary function.
Padula, Claudia B.; McQueeny, Tim; Lisdahl, Krista M.; Price, Jenessa S.; Tapert, Susan F.
Background Amygdala volume abnormalities have been reported in relation to craving in substance-dependent adults, but it remains unclear if these effects are seen in adolescent marijuana (MJ) users, particularly following abstinence. Objectives The aim of this study was to examine the relationship between amygdala volume and craving during 28 days of abstinence in adolescent MJ users. Methods MJ-using adolescents (n = 22) aged 16–19 were recruited as part of a larger study on brain function in teen drug users. Craving measures were collected twice per week throughout a 28-day abstinence period. High-resolution anatomical magnetic resonance imaging data were collected at the end of the 28 days of confirmed abstinence. Left and right amygdala volumes were traced by hand (ICC>0.86). Composite scores for self-reported craving and withdrawal symptoms throughout the 28-day abstinence period were calculated to provide four composite measures of total craving, mood, sleep, and somatic complaints. Results Results revealed that greater craving during abstinence was significantly associated with smaller left and right amygdala volumes, after controlling for age and gender. Other measures of withdrawal, including mood, somatic complaints and sleep problems, were not related to amygdala morphometry. Conclusion These results are consistent with previous findings in adult alcohol-and cocaine-dependent individuals, who demonstrated a relationship between reduced amygdala volumes and increased craving. Future studies are needed to determine if these brain-behavior relationships are attributable to MJ use or predate the onset of substance use. PMID:25668330
Amaral, Gorette; Geierstanger, Sara; Soleimanpour, Samira; Brindis, Claire
Background: The purpose of this study is to compare the mental health risk profile and health utilization behaviors of adolescent school-based health center (SBHC) users and nonusers and discuss the role that SBHCs can play in addressing adolescent health needs. Methods: The sample included 4640 students in grades 9 and 11 who completed the…
Delmore, T; Kalagian, W F; Loewen, I R
Clients in birth control centers (St. Catharines, Niagara Falls, and Welland) in Ontario, Canada were profiled in 1989; factors affecting compliance with the use of oral contraceptives (OCs) were investigated. Compliance was assessed for those 16 years and after 3 months of OC use. A control group and 2 study groups were randomly formed. 1 group was told about a follow up telephone call if the 3-month checkup appointment was not kept and the other not told. Compliance was determined by keeping the follow-up appointment and taking the pill as directed. Self-administered questionnaires were obtained at the 1st appointment and the 2nd study group was interviewed at the 3-month appointment time. Of the 334 intake interviews, 28.4% were adolescents 16 years old. Information on birth control came most frequently from friends (78.7%; then high school classmates, 61.4% grade school classmates, 61.4%; and family, 38.0%). 94.3% had a boyfriend, primarily a steady one. 82.4% were sexually active before the Center visit. 21.3% had had sex when 15 years old. 9.2% of those sexually active had never used birth control. 85.2% of those using contraception had used a condom at least once, and 33.9% used withdrawal. In the preceding month, birth control was used 60% of the time. 46% of mothers and 25% of fathers were considered supportive of birth control. 228 16 years participated in the compliance study. The 2 study groups and the control group were not significantly different in their compliance. The only statistically significant predictor of compliance (from the intake interview) was the previous use of the condom. Those more likely to be compliant were the 10.9% sexually active who had never used a condom. Continuing with the family doctor, not sexually active, advice to stop, side effects concerns, and remembering to take the pill were the most common reasons for noncompliance. The implication for health and sex education is that emphasis needs to the placed on the risks taken
Ebbert, Jon O.; Glover, Elbert D.; Shinozaki, Eri; Schroeder, Darrell R.; Dale, Lowell C.
Objectives: To investigate predictors of tobacco abstinence among smokeless tobacco (ST) users. Methods: Logistic regression analyses assessed characteristics associated with tobacco abstinence among ST users receiving bupropion SR. Results: Older age was associated with increased tobacco abstinence in both placebo and bupropion SR groups at end…
McDermott, Steven T.; And Others
Prior to the 1986 advertising ban, a study measured the effects of smokeless tobacco advertising on young people. A questionnaire was administered in the spring of 1985 to 133 sixth, eighth, and tenth grade students in rural Georgia. The probability of exposure to smokeless tobacco ads was measured by: (1) the number of hours per week the student…
Introduction: Studies of social characteristics and substance use patterns among young users of water pipe are rare in Western countries, and no such study has been conducted in Sweden. Methods: Cross-sectional study based on a national survey conducted in 2011, including 4,710 primary school students (15 years of age) and 3,624 high school students (17 years of age). Prevalence of lifetime and current water pipe use was compared among subgroups defined by other substance use, that is, cigarettes, snus, alcohol, and illicit drugs. Logistic regression was employed to calculate odds ratios (OR) of water pipe use and corresponding 95% confidence intervals (CI), conditionally on sociodemographic characteristics. Results: Use of water pipe was associated with the use of other substances in both age groups. In particular, current use of water pipe at the age of 15 years was strongly associated with current cigarette smoking (OR = 6.46; CI = 5.13–8.14); use of snus (OR = 5.62; CI = 3.94–7.96); binge drinking (OR = 7.39; CI = 5.88–9.31); drunkenness (OR = 7.05; CI = 5.60–8.88); and recent use of illicit drugs (OR = 14.20; CI = 9.18–22.19). Annual alcohol consumption predicted water pipe use in a dose–response fashion. Cigarette smokers willing to quit used water pipe to a lower extent than smokers who did not intend to quit. Being an exclusive smoker of water pipe was associated with substance use when compared with a nonsmoker of tobacco, but not when compared with an exclusive smoker of cigarettes. Conclusions: Water pipe use among adolescents in Sweden is not a recreational tobacco use alternative to cigarettes and should be regarded as a marker of multiple substance use. PMID:25140043
FOGT, DONOVAN L.; LEVI, MICHAEL A.; RICKARDS, CAROLINE A.; STELLY, STEVEN P.; COOKE, WILLIAM H.
Smokers, and even non-smokers, may utilize vaporized nicotine delivered by electronic cigarette (EC) due to the perception that EC are “healthier” than traditional tobacco cigarettes. The effects of vaporized nicotine delivered by EC on resting blood pressure (BP) and resting metabolic rate (RMR), or BP and aerobic power during exercise have not been studied. This investigation tested the effects of acute vaporized nicotine inhalation by EC on resting BP and RMR and cycle exercise BP, metabolic responses, and aerobic power in young, normotensive non-smokers. Using a double-blind design, 20 subjects (10 female) participated in two randomized trials: placebo (0 mg nicotine) or nicotine (18 mg nicotine). Participants inhaled from EC once every 30 s for 10 min (20 inhalations total). RMR was assessed 40 min later by indirect calorimetry followed by an incremental cycle test. RMR was not different between trials (p=0.79). Compared to the placebo, resting diastolic pressure (DBP) was 3 mmHg higher with nicotine (p=0.04). VO2peak was not different between the nicotine trial (2.3±0.8 L•min−1) and placebo (2.3±0.7 L•min−1) trials (p=0.77), and Wmax was also similar between nicotine (201.0±53.8 W) and the placebo (204.8±57.8 W) (p=0.29). During the cycle exercise test, average DBP was higher following nicotine use compared with placebo trial (p=0.05), and exercise DBPpeak after nicotine (79.4±7.6) was significantly higher than placebo (74.9±8.3 mmHg) (p=0.02). Resting systolic blood pressure (SBP) was 3.7 mmHg lower for nicotine trial (p=0.04) but no SBP treatment effect was observed during exercise (p=0.14). Our results show that acute vaporized nicotine inhalation via EC increases resting and exercise DBP but does not affect RMR or cycle aerobic power in young, normotensive non-smokers. PMID:27990223
Neff, Linda J; Arrazola, René A; Caraballo, Ralph S; Corey, Catherine G; Cox, Shanna; King, Brian A; Choiniere, Conrad J; Husten, Corinne G
The use of tobacco products during adolescence increases the risk for adverse health effects and lifelong nicotine addiction. In 2014, an estimated 4.6 million middle and high school students were current users of any tobacco product, of whom an estimated 2.2 million were current users of two or more types of tobacco products. Symptoms of nicotine dependence are increased for multiple tobacco product users compared with single-product users. CDC and the Food and Drug Administration (FDA) analyzed data from the 2014 National Youth Tobacco Survey (NYTS) to determine how frequently (the number of days in the preceding 30 days) U.S. middle school (grades 6–8) and high school (grades 9–12) students used cigarettes, e-cigarettes, cigars, and smokeless tobacco products. Among current users (≥1 day during the preceding 30 days) in high school, frequent use (≥20 days during the preceding 30 days) was most prevalent among smokeless tobacco users (42.0%), followed by cigarette smokers (31.6%), e-cigarette users (15.5%), and cigar smokers (13.1%); a similar pattern was observed for those who used during all 30 days. Among current users in middle school, frequent use was greatest among smokeless tobacco users (29.2%), followed by cigarette smokers (20.0%), cigar smokers (13.2%) and e-cigarette users (11.8%). Current use of two or more types of tobacco products was common, even among students who used tobacco products 1–5 days during the preceding 30 days: 77.3% for cigar smokers, 76.9% for cigarette smokers, 63.4% for smokeless tobacco users, and 54.8% for e-cigarettes users. Preventing youths from initiating the use of any tobacco product is important to tobacco use prevention and control strategies in the United States. Monitoring the frequency and patterns of tobacco use among youths, including the use of two or more tobacco products, is important to inform evidence-based interventions to prevent and reduce all forms of tobacco use among youths.
Cranwell, Jo; Opazo-Breton, Magdalena; Britton, John
Background We estimate exposure of British adults and adolescents to tobacco and alcohol content from a sample of popular YouTube music videos. Methods British viewing figures were generated from 2 representative online national surveys of adult and adolescent viewing of the 32 most popular videos containing content. 2068 adolescents aged 11–18 years (1010 boys, 1058 girls), and 2232 adults aged 19+years (1052 male, 1180 female) completed the surveys. We used the number of 10 s intervals in the 32 most popular videos containing content to estimate the number of impressions. We extrapolated gross and per capita impressions for the British population from census data and estimated numbers of adults and adolescents who had ever watched the sampled videos. Results From video release to the point of survey, the videos delivered an estimated 1006 million gross impressions of alcohol (95% CI 748 to 1264 million), and 203 million of tobacco (95% CI 151 to 255 million), to the British population. Per capita exposure was around 5 times higher for alcohol than for tobacco, and nearly 4 times higher in adolescents, who were exposed to an average of 52.1 (95% CI 43.4 to 60.9) and 10.5 (95% CI 8.8 to 12.3) alcohol and tobacco impressions, respectively, than in adults (14.1 (95% CI 10.2 to 18.1) and 2.9 (95% CI 2.1 to 3.6)). Exposure rates were higher in girls than in boys. Conclusions YouTube music videos deliver millions of gross impressions of alcohol and tobacco content. Adolescents are exposed much more than adults. Music videos are a major global medium of exposure to such content. PMID:26767404
Godley, Susan Harrington; Meyers, Robert J.; Smith, Jane Ellen; Karvinen, Tracy; Titus, Janet C.; Godley, Mark D.; Dent, George; Passetti, Lora; Kelberg, Pamela
This publication was written for therapists and their supervisors who may want to implement the adolescent community reinforcement approach intervention, which was one of the five interventions tested by the Center for Substance Abuse Treatment's (CSAT's) Cannabis Youth Treatment (CYT) Project. The CYT Project provided funding to support a study…
Vardavas, Constantine I.; Connolly, Gregory
Introduction: NNAL [4-(methylnitrosamino)-1-(3-pyridyl)-1-butanonol] is a valid biomarker of tobacco use. However; no study has assessed its use in distinguishing current smokeless tobacco (SLT) users from nonusers. Therefore, this study used aggregated data from the 2007–2008 and 2009–2010 waves of the National Health and Nutrition Examination Survey to determine an optimal threshold for identifying SLT users with NNAL. Methods: Optimal urinary total NNAL concentrations for discriminating SLT-only users from nonusers of any tobacco were determined using receiver operating characteristic analysis. Percentage agreement between self-reported SLT use status and NNAL levels was calculated overall and by sociodemographic characteristics. All analyses were weighted and performed with Stata, Version 11, and MedCalc for Windows, Version 220.127.116.11. Results: In total, 264 individuals reported exclusively using SLT (and no other combustible tobacco product) within the past 5 days, whereas 14,824 were self-reported nonusers of any combustible or smokeless tobacco product. The optimal NNAL cutoff point was 34.0 pg/ml, which was associated with a high sensitivity (95.2%), specificity (93.4%), and overall correct classification rate (93.5%). The area under the curve was 98.3% and the corresponding Youden’s Index was 88.7%. There was high agreement between the proposed NNAL cutoff point and self-reported SLT-only use (95.6%) and self-reported SLT nonuse (93.9%). Conclusion: The proposed cutoff point of 34.0 pg/ml had high sensitivity and specificity and may be used by clinicians and researchers to verify or detect recent SLT use. This study also indicated that self-reported SLT use among adults is a reliable measure and has high agreement with biochemical assessment. PMID:23956252
Background Translational Medicine focuses on “bench to bedside”, converting experimental results into clinical use. The “bedside to bench” transition remains challenging, requiring clinicians to define true clinical need for laboratory study. In this study, we show how observational data (an eleven-year data survey program on adolescent smoking behaviours), can identify knowledge gaps and research questions leading directly to clinical implementation and improved health care. We studied gender-specific trends (2000–2010) in Italian students to evaluate the specific impact of various anti-smoking programs, including evaluation of perceptions of access to cigarettes and health risk. Methods The study used, ESPAD-Italia® (European School Survey Project on Alcohol and other Drugs), is a nationally representative sample of high-school students. The permutation test for joinpoint regression was used to calculate the annual percent change in smoking. Changes in smoking habits by age, perceived availability and risk over a 11-year period were tested using a gender-specific logistic model and a multinomial model. Results Gender-stratified analysis showed 1) decrease of lifetime prevalence, then stabilization (both genders); 2) decrease in last month and occasional use (both genders); 3) reduction of moderate use (females); 4) no significant change in moderate use (males) and in heavy use (both genders). Perceived availability positively associates with prevalence, while perceived risk negatively associates, but interact with different effects depending on smoking patterns. In addition, government implementation of public policies concerning access to tobacco products in this age group during this period presented a unique background to examine their specific impact on behaviours. Conclusion Large observational databases are a rich resource in support of translational research. From these observations, key clinically relevant issues can be identified and form the
Koenig, Kevin T.; Ramos, Mary M.; Fowler, Tara T.; Oreskovich, Kristin; McGrath, Jane; Fairbrother, Gerry
Background: The purpose of this study is to describe patterns of care and service use among adolescent school-based health center (SBHC) users in New Mexico and contrast patterns and services between frequent and infrequent users. Methods: Medical claims/encounter data were analyzed from 59 SBHCs located in secondary schools in New Mexico during…
Drummond, David; Baravalle-Einaudi, Mélissa; Lezmi, Guillaume; Vibhushan, Shamila; Franco-Montoya, Marie-Laure; Hadchouel, Alice; Boczkowski, Jorge; Delacourt, Christophe
Background: Fetal determinants of airway function, such as in utero exposure to maternal cigarette smoke (CS), may create a predisposition to adult airflow obstruction and chronic obstructive pulmonary disease (COPD) in adulthood. It has been suggested that active smoking in adolescence and preexisting airflow obstruction have synergistic deleterious effects. Objective: We used a mouse model to investigate whether there is a synergistic effect of exposure to CS in utero and during adolescence on lung function. Methods: Female C57Bl/6J mice were exposed to CS or to filtered room air during pregnancy. Exposure to CS began 2 weeks before mating and continued until delivery. After birth, the pups were not exposed to CS until day 21 (D21). Between D21 and D49, corresponding to “adolescence,” litters were randomized for an additional 4 weeks of exposure to CS. Lung morphometry, lung mechanics, and the expression of genes involved in senescence were evaluated in different subsets of mice on D21 and D49. Results: In utero exposure to CS induced significant lung function impairment by D21. CS exposure between D21 and D49 induced significant functional impairment only in mice exposed to CS prenatally. On D49, no difference was observed between subgroups in terms of lung p53, p16, p21, and Bax mRNA levels. Conclusions: Our findings suggest that prenatal and adolescent CS exposure have a synergistic effect on lung function in mice. The combined effect did not appear to be a consequence of early pulmonary senescence. Citation: Drummond D, Baravalle-Einaudi M, Lezmi G, Vibhushan S, Franco-Montoya ML, Hadchouel A, Boczkowski J, Delacourt C. 2017. Combined effects of in utero and adolescent tobacco smoke exposure on lung function in C57Bl/6J mice. Environ Health Perspect 125:392–399; http://dx.doi.org/10.1289/EHP54 PMID:27814244
Bennett, David S.; Mohamed, Feroze B.; Carmody, Dennis P.; Bendersky, Margaret; Patel, Sunil; Khorrami, Maryam; Faro, Scott H.; Lewis, Michael
Children prenatally exposed to tobacco have been found to exhibit increased rates of behavior problems related to response inhibition deficits. The present study compared the brain function of tobacco-exposed (n = 7) and unexposed (n = 11) 12-year-olds during a Go/No-Go response inhibition task using an event-related functional MRI (fMRI) design. Prenatal alcohol exposure, neonatal medical problems, environmental risk, IQ, current environmental smoke exposure, and handedness were statistically controlled. Tobacco-exposed children showed greater activation in a relatively large and diverse set of regions, including left frontal, right occipital, and bilateral temporal, and parietal regions. In contrast, unexposed but not exposed children showed activation in the cerebellum, which prior research has indicated is important for attention and motor preparation. The diversity of regions showing greater activation among tobacco-exposed children suggests that their brain function is characterized by an inefficient recruitment of regions required for response inhibition. PMID:19351556
Bennett, David S; Mohamed, Feroze B; Carmody, Dennis P; Malik, Muhammed; Faro, Scott H; Lewis, Michael
Children prenatally exposed to tobacco exhibit higher rates of learning and emotional-behavioral problems related to worse working memory performance. Brain function, however, among tobacco exposed children while performing a working memory task has not previously been examined. This study compared the brain function of tobacco-exposed (n = 7) and unexposed (n = 11) 12-year-olds during a number N-back working memory task using an event-related functional magnetic resonance imaging (fMRI) design. Prenatal alcohol exposure, neonatal medical problems, environmental risk, and sex were statistically controlled. Tobacco-exposed children showed greater activation in inferior parietal regions, whereas unexposed children showed greater activation in inferior frontal regions. These differences were observed in the context of correct responses, suggesting that exposed and unexposed children use different brain regions and approaches to succeed in working memory tasks. Implications for future research and intervention are discussed.
García-Sánchez, Sara; Matalí, Josep Lluís; Martín-Fernández, María; Pardo, Marta; Lleras, Maria; Castellano-Tejedor, Carmina; Haro, Josep Maria
Cannabis is the illicit substance most widely used by adolescents. Certain personality traits such as impulsivity and sensation seeking, and the subjective effects experienced after substance use (e.g. euphoria or relaxation) have been identified as some of the main etiological factors of consumption. This study aims to categorize a sample of adolescent cannabis users based on their most dominant personality traits (internalizing and externalizing profile). Then, to make a comparison of both profiles considering a set of variables related to consumption, clinical severity and subjective effects experienced. From a cross-sectional design, 173 adolescents (104 men and 69 women) aged 13 to 18 asking for treatment for cannabis use disorder in an Addictive Behavior Unit (UCAD) from the hospital were recruited. For the assessment, an ad hoc protocol was employed to register consumption, the Millon Adolescent Clinical Inventory (MACI) and the Addiction Research Center Inventory (ARCI) 49-item short form were also administered. Factor analysis suggested a two-profile solution: Introverted, Inhibited, Doleful, Dramatizing (-), Egotistic (-), Self-demeaning and Borderline tendency scales composed the internalizing profile, and Submissive (-), Unruly, Forceful, Conforming (-) and Oppositional scales composed the externalizing profile. The comparative analysis showed that the internalizing profile has higher levels of clinical severity and more subjective effects reported than the externalizing profile. These results suggest the need to design specific intervention strategies for each profile.
Schweinsburg, Alecia D.; Nagel, Bonnie J.; Schweinsburg, Brian C.; Park, Ann; Theilmann, Rebecca J.; Tapert, Susan F.
Marijuana is the most widely used illicit substance among teenagers, yet little is known about the possible neural influence of heavy marijuana use during adolescence. We previously demonstrated an altered functional magnetic resonance imaging (fMRI) activity related to spatial working memory (SWM) among adolescents who were heavy users of after an average of 8 days of abstinence, but the persisting neural effects remain unclear. To characterize the potentially persisting neurocognitive effects of heavy marijuana use in adolescence, we examined fMRI response during SWM among abstinent marijuana-using teens. Participants were 15 MJ teens and 17 demographically similar non-using controls, ages 16–18. Teens underwent biweekly urine toxicology screens to ensure abstinence for 28 days before fMRI acquisition. Groups performed similarly on the SWM task, but MJ teens demonstrated lower activity in right dorsolateral prefrontal and occipital cortices, yet significantly more activation in right posterior parietal cortex. MJ teens showed abnormalities in brain response during a SWM task compared with controls, even after 1 month of abstinence. The activation pattern among MJ teens may reflect different patterns of utilization of spatial rehearsal and attention strategies, and could indicate altered neurodevelopment or persisting abnormalities associated with heavy marijuana use in adolescence. PMID:18356027
Background There is strong evidence of an association between maternal smoking during pregnancy and restriction of intrauterine growth, but the effects of this exposure on postnatal linear growth are not well defined. Furthermore, few studies have investigated the role of tobacco smoke exposure also after pregnancy on linear growth until adolescence. In this study we investigated the effect of maternal smoking exposure during pregnancy and preschool age on linear growth from birth to adolescence. Methods We evaluated a cohort of children born between 1994 and 1999 in Cuiabá, Brazil, who attended primary health clinics for vaccination between the years 1999 and 2000 (at preschool age) and followed-up after approximately ten years. Individuals were located in public and private schools throughout the country using the national school census. Height/length was measured, and length at birth was collected at maternity departments. Stature in childhood and adolescence was assessed using the height-for-age index sex-specific expressed as z-score from curves published by the World Health Organization. Linear mixed effects models were used to estimate the association between exposure to maternal smoking, during pregnancy and preschool age, and height of children assessed at birth, preschool and school age, adjusted for age of the children. Results We evaluated 2405 children in 1999–2000, length at birth was obtained from 2394 (99.5%), and 1716 at follow-up (71.4% of baseline), 50.7% of the adolescents were male. The z-score of height-for-age was lower among adolescents exposed to maternal smoking both during pregnancy and childhood (p < 0.01). Adjusting for age, sex, maternal height, maternal schooling, socioeconomic position at preschool age, and breastfeeding, children exposed to maternal smoking both during pregnancy and preschool age showed persistent lower height-for-age since birth to adolescence (coefficient: −0.32, p < 0.001) compared to non
DiFranza, Joseph R.; Ursprung, W. W. Sanouri; Carson, Alisha
Nicotine addiction is the most common preventable cause of premature death presenting during adolescence. No prior study has described the onset of this condition based on case histories. We used trained personnel to conduct individual semi-structured interviews to obtain case histories from 50 adolescent and young adult current and former…
Masiero, Marianna; Riva, Silvia; Fioretti, Chiara; Pravettoni, Gabriella
Scholars underline the pivotal role of tobacco cigarette smoking in carcinogenesis process for blood tumors. A controversial debate is represented by the diffusion of tobacco use in young cancer survivors that had a previous diagnosis of blood tumor during the childhood. Compared with their peers, scientific evidence highlights that pediatric survivors have more difficult to give-up cigarette smoking. Furthermore, tobacco-smoking is frequently linked with others risk behaviors as drinking or substance abuse. In reviewing the main knowledge on this topic, authors affirm the need for increasing research on blood cancer survivors in order to depict psychological characteristics of pediatric blood cancer survivors. Improving health decision-making skills in young survivors could reduce the risk to adopt un-healthy behaviors and increase psychological wellbeing. Furthermore, authors propose tailored antismoking interventions based on the knowledge of the psychological and cognitive factors that support smoking during the transition toward emerging-adulthood. PMID:27047419
Schweinsburg, Alecia D.; Schweinsburg, Brian C.; Medina, Krista Lisdahl; McQueeny, Tim; Brown, Sandra A.; Tapert, Susan F.
Some neurocognitive recovery occurs within a month of abstinence from heavy marijuana use, yet functional magnetic resonance imaging (fMRI) has revealed altered activation among recent and abstinent adult users. Here, we compared fMRI response during a spatial working memory (SWM) task between adolescent marijuana users with brief and sustained durations of abstinence. Participants were 13 recent users (2 – 7 days abstinent), 13 abstinent users (27 – 60 days abstinent), and 18 non-using controls, all ages 15 – 18. Groups were similar on demographics, had no psychiatric or medical disorders, and user groups were similar on substance histories. Teens performed a 2-back SWM task during fMRI. Groups performed similarly on the task, but recent users showed greater fMRI response in medial and left superior prefrontal cortices, as well as bilateral insula. Abstinent users had increased response in the right precentral gyrus (clusters ≥1328 μl, p<.05). This cross-sectional study did not examine changes in brain response among the same participants over time. Yet results suggests that adolescents who recently used marijuana show increased brain activity in regions associated with working memory updating and inhibition, compared to users with weeks to months of abstinence. This study preliminarily suggests that (1) recent marijuana use may disrupt neural connections associated with SWM and result in compensatory brain response, and (2) sustained abstinence from marijuana may be associated with improvements in SWM response among adolescents. PMID:21053763
Rende, Richard; Boergers, Julie; Abrams, David B.; Buka, Stephen L.; Clark, Melissa A.; Colby, Suzanne M.; Hitsman, Brian; Kazura, Alessandra N.; Lipsitt, Lewis P.; Lloyd-Richardson, Elizabeth E.; Rogers, Michelle L.; Stanton, Cassandra A.; Stroud, Laura R.; Niaura, Raymond S.
Objective Adolescence is an important period of risk for the development of lifelong smoking behaviors. Compelling, although inconsistent, evidence suggests a relation between parental smoking and the risk of smoking initiation during adolescence. This study investigates unresolved issues concerning the strength and nature of the association between parent smoking and offspring smoking initiation. Methods We enrolled 564 adolescents aged 12-17, along with one of their parents, into the New England Family Study between 2001-2004. Lifetime smoking histories were obtained from parents and their adolescent offspring. Discrete-time survival analysis was used to investigate the influence of parental smoking histories on the risk of adolescent smoking initiation. Results Parental smoking was associated with a significantly higher risk of smoking initiation in adolescent offspring (odds ratio=2.81, 95% CI=1.78, 4.41). In addition, the likelihood of offspring smoking initiation increased with the number of smoking parents and the duration of exposure to parental smoking, suggesting a dose-response relation between parental smoking and offspring smoking. Offspring of parents who had quit smoking were no more likely to smoke than offspring of parents who had never smoked. The effects of parental smoking on offspring initiation differed by sex (with a stronger effect of father's smoking on boys than girls), developmental period (with a stronger effect of parental smoking before the adolescent was age 13 than afterwards), and residence of parents (with effects of father's smoking being dependent on living in the same household as the adolescent). Parental smoking was also associated with stronger negative reactions to adolescents' first cigarette, a potential marker of the risk of progression to higher levels of use. Conclusions Parental smoking is an important source of vulnerability to smoking initiation among adolescents, and parental smoking cessation might attenuate this
Capaldi, Deborah M.; Tiberio, Stacey S.; Kerr, David C. R.; Pears, Katherine C.
Objective: This study examined whether the use of tobacco and marijuana by fathers or mothers predicted onset of alcohol use in their offspring over and above effects of parental alcohol use. Method: The present study included 146 children of 93 parents (90 fathers and 85 mothers). The fathers were originally recruited as boys to the Oregon Youth Study, a study of community, familial, and individual risk factors for delinquency. Results: Only mothers’ but not fathers’ alcohol use was associated with children’s age at onset. Children’s age at onset was predicted by mothers’ tobacco use and by the interaction of fathers’ marijuana use and alcohol use. These effects were observed when controlling for parental education, child’s gender, and also child’s antisocial behavior—a general developmental risk factor for substance use onset in adolescence. Conclusions: Mothers’ substance use played a major role in childhood onset of alcohol use, yet the role of maternal substance use as a risk factor for their children has previously received less attention than the role of paternal substance use. Also, findings imply that it may be important to identify children of polysubstance-using parents for targeted prevention programs. PMID:26751359
Dysterheft, Jennifer L.; Rice, Ian M.; Rice, Laura A.
Ten full-time adolescent wheelchair users (ages 13–18) completed a total of three propulsion trials on carpet and tile surfaces, at a self-selected velocity, and on a concrete surface, at a controlled velocity. All trials were performed in their personal wheelchair with force and moment sensing wheels attached bilaterally. The first two trials on each surface were used as pre-intervention control trials. The third trial was performed after receiving training on proper propulsion technique. Peak resultant force, contact angle, stroke frequency, and velocity were recorded during all trials for primary analysis. Carpet and tile trials resulted in significant increases in contact angle and peak total force with decreased stroke frequency after training. During the velocity controlled trials on concrete, significant increases in contact angle occurred, as well as decreases in stroke frequency after training. Overall, the use of a training video and verbal feedback may help to improve short-term propulsion technique in adolescent wheelchair users and decrease the risk of developing upper limb pain and injury. PMID:26042217
Dysterheft, Jennifer L; Rice, Ian M; Rice, Laura A
Ten full-time adolescent wheelchair users (ages 13-18) completed a total of three propulsion trials on carpet and tile surfaces, at a self-selected velocity, and on a concrete surface, at a controlled velocity. All trials were performed in their personal wheelchair with force and moment sensing wheels attached bilaterally. The first two trials on each surface were used as pre-intervention control trials. The third trial was performed after receiving training on proper propulsion technique. Peak resultant force, contact angle, stroke frequency, and velocity were recorded during all trials for primary analysis. Carpet and tile trials resulted in significant increases in contact angle and peak total force with decreased stroke frequency after training. During the velocity controlled trials on concrete, significant increases in contact angle occurred, as well as decreases in stroke frequency after training. Overall, the use of a training video and verbal feedback may help to improve short-term propulsion technique in adolescent wheelchair users and decrease the risk of developing upper limb pain and injury.
Sussman, Steve; And Others
Showed videotapes designed to affect personal level judgments of concern and risk in context of smokeless tobacco use to 388 tenth graders, manipulating either message convincingness or perceived probability of consequences portrayed in message. Results suggest that media manipulation of probability of consequences would be more effective than…
Elder, John P.; And Others
This study investigated the usefulness of a telephone-based intervention in circumventing participant biases in school-based tobacco use prevention programs. Researchers attempted to conduct telephone interventions with ninth graders and found it difficult to reach a large portion of targeted individuals. Results provided data on which adolescents…
Hansen, William B.; And Others
Programs which have been somewhat effective in reducing the rates of onset of regular tobacco use have featured such components as peer pressure resistance training, correction of normative expectations, inoculation against mass media messages, information about parental influences, information about consequences of use, public commitments, or…
Chen, Lian-Yu; Crum, Rosa M.; Strain, Eric C.; Martins, Silvia S.; Mojtabai, Ramin
Objectives There are growing concerns about nonmedical use of ADHD stimulants among adolescents; yet, little is known whether there exist heterogeneous subgroups among adolescents with nonmedical ADHD stimulant use according to their concurrent substances use. Methods We used latent class analysis (LCA) to examine patterns of past-year problematic substance use (meeting any criteria for abuse or dependence) in a sample of 2,203 adolescent participants from the National Surveys on Drug Use and Health 2006–2011 who reported past-year nonmedical use of ADHD stimulants. Multivariable latent regression was used to assess the association of socio-demographic characteristics, mental health and behavioral problems with the latent classes. Results The model fit indices favored a four-class model, including a large class with frequent concurrent use of alcohol and marijuana (Alcohol/Marijuana class; 41.2%), a second large class with infrequent use of other substances (Low substance class, 36.3%), a third class characterized by more frequent misuse of prescription drugs as well as other substances (Prescription drug+ class; 14.8%), and finally a class characterized by problematic use of multiple substances (Multiple substance class; 7.7%). Compared with individuals in Low substance class, those in the other three classes were all more likely to report mental health problems, deviant behaviors and substance abuse service use. Conclusions Adolescent nonmedical ADHD stimulants users are a heterogeneous group with distinct classes with regard to concurrent substance use, mental health and behavioral problems. The findings have implications for planning of tailored prevention and treatment programs to curb stimulant use for this age group. PMID:26026384
Arain, Sadaf Sadia; Kazi, Tasneem Gul; Afridi, Hassan Imran; Brahman, Kapil Dev; Naeemullah; Khan, Sumaira; Panhwar, Abdul Haleem; Kamboh, Muhammad Afzal; Memon, Jamil R
The present study was aimed to evaluate the cadmium (Cd) and lead (Pb) levels in the blood samples of adolescent boys, chewing different smokeless tobacco (SLT) products in Pakistan. For comparative purpose, boys of the same age group (12-15 years), not consumed any SLT products were selected as referents. To determine trace levels of Cd and Pb in blood samples, a preconcentration method, vortex-assisted liquid-liquid microextraction (VLLME) has been developed, prior to analysis by flame atomic absorption spectrometry. The hydrophobic chelates of Cd and Pb with ammonium pyrrolidinedithiocarbamate were extracted into the fine droplets of ionic liquid (IL) 1-butyl-3-methylimidazolium hexafluorophosphate, while nonionic surfactant, Triton X-114 was used as a dispersing medium. The main factors affecting the recoveries of Cd and Pb, such as concentration of APDC, centrifugation time, volume of IL and TX-114, were investigated in detail. It was also observed that adolescent boys who consumed different SLT products have 2- to 3-fold higher levels of Cd and Pb in their blood samples as compared to referent boys (p < 0.001).
Sabnis, Rajesh; Sahu, Kamtaram; Thakur, Deepak; Surana, Sanidhya; Mazhar, Heena; Pandey, Soumy
Aims and Objectives: To assess and compare the tobacco use prevalence; to understand and compare attitudes and knowledge related to tobacco use and its health impact among urban and rural students; and to assess urban and rural disparity in the use of tobacco among 12 and 15-year-old adolescents in the urban and rural schools in Chhattisgarh, India. Materials and Methods: A cross-sectional study was conducted among 12 and 15-year-old and urban and rural school going children in Durg District. Scientifically, based on the data obtained from the pilot study, sample size was calculated. A total of 1000 children were selected to be a part of the study and were interviewed face-to-face using a detailed pretested, close-ended questionnaire. The Statistical Package for the Social Sciences version 16.0 (SPSS Pvt. Ltd, Chicago, IL, USA) was used for the statistical analyses. Results: Prevalence of tobacco consumption was 48.8%. Males were involved predominantly in consuming tobacco. The knowledge and attitude was better in the school children of urban areas than the school children of rural areas; more of the urban school children were involved in smoking cigarette. Rural children outnumbered urban children in the smokeless tobacco consumption. Conclusion: Prevalence of tobacco consumption among school children remains high with a wide disparity among urban and rural children. There is an urgent need to have a rural orientation in the National Tobacco Control Program that is currently being developed by the Government of India and giving relevance to the youth. PMID:28217541
Tang, Jie; Yu, Yizhen; Du, Yukai; Ma, Ying; Zhang, Dongying; Wang, Jiaji
Internet addiction (IA) among adolescents is a serious public health problem around the world. However, there have been few studies that examine the association between IA and stressful life events and psychological symptoms among Chinese adolescent internet users. We examined the association between IA and stressful life events and psychological symptoms among a random sample of school students who were internet users (N=755) in Wuhan, China. Internet addiction, stressful life events, coping style and psychological symptoms were measured by self-rated scales. The prevalence rate of internet addiction was 6.0% among adolescent internet users. Logistic regression analyses indicated that stressors from interpersonal problem and school related problem and anxiety symptoms were significantly associated with IA after controlling for demographic characteristics. Analyses examining the coping style with the IA revealed that negative coping style may mediate the effects of stressful life events to increase the risk of IA. However, no significant interaction of stressful life events and psychological symptoms was found. These findings of the current study indicate a high prevalence of internet addiction among Chinese adolescent internet users and highlight the importance of stressors from interpersonal problem and school related problem as a risk factor for IA which mainly mediated through negative coping style.
Strukcinskiene, Birute; Uğur-Baysal, Serpil; Raistenskis, Juozas
This study analyzes traffic mortality trends among road users from 1998 to 2012 in children and adolescents aged 0-19 years in Lithuania. National mortality data of pedestrians, cyclists, motorcyclists, and car occupants were used to compare trend lines. The study revealed that 56% of the deceased in road traffic crashes were car occupants, while 24% were pedestrians. The incidence of death from traffic injury was 2.5 times higher in boys than girls. Traffic injury mortality and pedestrian mortality rates declined significantly in the total group. There was also a significant decline in mortality among cyclists for the total group and female subgroup. Trends in mortality rates among motorcyclists and car occupants showed no significant changes. A long-term decline is more likely to be affected by efforts in the promotion of sustainable and permanent road safety. The reduced risk exposure may also have been influenced by the economic recession.
Kekatpure, Vikram D; Bs, Naveen; Wang, Hanhan; Zhou, Xi Kathy; Kandasamy, Chandramohan; Sunny, Sumsum P; Suresh, Amritha; Milne, Ginger L; Kuriakose, Moni Abraham; Dannenberg, Andrew J
Cyclooxygenase-2 (COX-2)-derived prostaglandin E2 (PGE2) plays a role in the development and progression of epithelial malignancies. Measurements of urinary PGE-M, a stable metabolite of PGE2, reflect systemic PGE2 levels. Here, we investigated whether urinary PGE-M levels were elevated in healthy tobacco users and in patients with oral squamous cell carcinoma (OSCC). Median urinary PGE-M levels were increased in healthy tobacco quid chewers [21.3 ng/mg creatinine (Cr); n = 33; P = 0.03] and smokers (32.1 ng/mg Cr; n = 31; P < 0.001) compared with never tobacco quid chewers-never smokers (18.8 ng/mg Cr; n = 30). Urinary PGE-M levels were also compared in OSCC patients versus healthy tobacco users. An approximately 1-fold increase in median urinary PGE-M level was found in OSCC patients (48.7 ng/mg Cr, n = 78) versus healthy controls (24.5 ng/mg Cr, n = 64; P < 0.001). We further determined whether baseline urinary PGE-M levels were prognostic in OSCC patients who underwent treatment with curative intent. A nearly 1-fold increase in baseline urinary PGE-M levels (64.7 vs. 33.8 ng/mg Cr, P < 0.001) was found in the group of OSCC patients who progressed (n = 37) compared with the group that remained progression free (n = 41). Patients with high baseline levels of urinary PGE-M had both worse disease-specific survival [HR, 1.01 per unit increase; 95% confidence interval (CI), 1.01-1.02; P < 0.001] and overall survival (HR, 1.01 per unit increase; 95% CI, 1.00-1.02; P = 0.03). Taken together, our findings raise the possibility that NSAIDs, prototypic inhibitors of PGE2 synthesis, may be beneficial for reducing the risk of tobacco-related aerodigestive malignancies or treating OSCC patients with high urinary PGE-M levels. Cancer Prev Res; 9(6); 428-36. ©2016 AACR.
Braciszewski, Jordan M.; Colby, Suzanne M.
Youth aging out of foster care face a challenging road to independence. Following exposure to myriad risk factors such as abuse, neglect, parental substance use, and severe housing mobility, supportive services decrease upon exit from care, often increasing risk for substance use, homelessness, and unemployment. Although tobacco use is also highly prevalent, little attention has been paid to screening, assessment, and treatment of tobacco use in this vulnerable group. The current study (N = 116) reports on tobacco use prevalence, consequences, and co-occurrence with other substances in a sample of youth (ages 18 to 19) exiting the foster care system. In the face of an overall decrease in tobacco use among general population adolescents and young adults, results suggest disproportionate levels of lifetime, recent, and daily use among foster youth. Prevalence of recent tobacco use (46%) is nearly triple national rates, while daily smoking (32%) is almost four times that of general population young adults. Tobacco users were more likely than non-users to drink (70% vs. 40%) and to smoke marijuana (72% vs. 25%). We strongly encourage researchers and practitioners to increase attention to this tobacco-related health disparity. PMID:26478645
Hunt, M; Fagan, P; Lederman, R; Stoddard, A; Frazier, L; Girod, K; Sorensen, G
Objective:To present feasibility data on SMART, the first teen worksite behavioural tobacco control intervention. Design:This phase II study was designed to estimate the efficacy and feasibility of a small scale, randomised, controlled intervention. Setting and subjects:This study, addressing youths aged 15–18 years, was implemented in four intervention and five control grocery stores that had an average of 44 eligible teens. Interventions:The tobacco use cessation and prevention interventions were based on social influences and peer leader models. Employee break rooms served as centres both for interactive activities including open houses, teen advisory boards, peer leader interviews, games and contests; and non-interactive interventions including bulletin boards and table tents with health messages and home mailings. Main process measures:Project staff collected process data on the extent of implementation of intervention activities, participation rates in activities, and contacts with peer leaders. On the final survey, teens reported on awareness of, participation in, and motivation for participating in project activities. Results:Indicators of feasibility were identified and discussed, including the number of activities implemented, teen participation, management support, cost, and barriers to and facilitators of implementation. During the 12 month intervention, a mean of 24.1 interactive activities and 55.3 non-interactive activities were implemented, and a mean 14.2% participation rate per activity per site was achieved. Eighty four per cent of teens reported being aware of SMART, and 39% reported participating in interactive and 67% in non-interactive activities. Conclusions:Teen smoking cessation rates in worksite programmes might be improved if they are conducted in companies where there is job stability and if teen programmes are part of worksite-wide tobacco control programmes that include both teens and adults. PMID:14645939
Soneji, Samir; Sargent, James D.; Tanski, Susanne E.; Primack, Brian A.
IMPORTANCE Many adolescents and young adults use alternative tobacco products, such as water pipes and snus, instead of cigarettes. OBJECTIVE To assess whether prior water pipe tobacco smoking and snus use among never smokers are risk factors for subsequent cigarette smoking. DESIGN, SETTING, AND PARTICIPANTS We conducted a 2-wave national longitudinal study in the United States among 2541 individuals aged 15 to 23 years old. At baseline (October 25, 2010, through June 11, 2011), we ascertained whether respondents had smoked cigarettes, smoked water pipe tobacco, or used snus. At the 2-year follow-up (October 27, 2012, through March 31, 2013), we determined whether baseline non–cigarette smokers had subsequently tried cigarette smoking, were current (past 30 days) cigarette smokers, or were high-intensity cigarette smokers. We fit multivariable logistic regression models among baseline non–cigarette smokers to assess whether baseline water pipe tobacco smoking and baseline snus use were associated with subsequent cigarette smoking initiation and current cigarette smoking, accounting for established sociodemographic and behavioral risk factors. We fit similarly specified multivariable ordinal logistic regression models to assess whether baseline water pipe tobacco smoking and baseline snus use were associated with high-intensity cigarette smoking at follow-up. EXPOSURES Water pipe tobacco smoking and the use of snus at baseline. MAIN OUTCOMES AND MEASURES Among baseline non–cigarette smokers, cigarette smoking initiation, current (past 30 days) cigarette smoking at follow-up, and the intensity of cigarette smoking at follow-up. RESULTS Among 1596 respondents, 1048 had never smoked cigarettes at baseline, of whom 71 had smoked water pipe tobacco and 20 had used snus at baseline. At follow-up, accounting for behavioral and sociodemographic risk factors, baseline water pipe tobacco smoking and snus use were independently associated with cigarette smoking
Vickerman, Katrina A; Kellogg, Elizabeth S; Zbikowski, Susan M
Background Phone-based tobacco cessation program effectiveness has been established and randomized controlled trials have provided some support for Web-based services. Relatively little is known about who selects different treatment modalities and how they engage with treatments in a real-world setting. Objective This paper describes the characteristics, Web utilization patterns, and return rates of tobacco users who self-selected into a Web-based (Web-Only) versus integrated phone/Web (Phone/Web) cessation program. Methods We examined the demographics, baseline tobacco use, Web utilization patterns, and return rates of 141,429 adult tobacco users who self-selected into a Web-Only or integrated Phone/Web cessation program through 1 of 10 state quitlines from August 2012 through July 2013. For each state, registrants were only included from the timeframe in which both programs were offered to all enrollees. Utilization data were limited to site interactions occurring within 6 months after registration. Results Most participants selected the Phone/Web program (113,019/141,429, 79.91%). After enrollment in Web services, Web-Only were more likely to log in compared to Phone/Web (21,832/28,410, 76.85% vs 23,920/56,892, 42.04%; P<.001), but less likely to return after their initial log-in (8766/21,832, 40.15% vs 13,966/23,920, 58.39%; P<.001). In bivariate and multivariable analyses, those who chose Web-Only were younger, healthier, more highly educated, more likely to be uninsured or commercially insured, more likely to be white non-Hispanic and less likely to be black non-Hispanic, less likely to be highly nicotine-addicted, and more likely to have started their program enrollment online (all P<.001). Among both program populations, participants were more likely to return to Web services if they were women, older, more highly educated, or were sent nicotine replacement therapy (NRT) through their quitline (all P<.001). Phone/Web were also more likely to return if they
Ramo, Danielle E.; Liu, Howard; Prochaska, Judith J.
Tobacco (TOB) and marijuana (MJ) are the most widely used drugs among adolescents and young adults. The literature on their co-use, however, has not been systematically reviewed. We identified 163 English language articles published from 1999-2009 examining TOB and MJ co-use, correlates or consequences of co-use, or interventions for prevention or cessation of couse with participants age 13-25 years. Most studies (n = 114, 70%) examined TOB and MJ couse, and 85% of relationships studied indicated a significant association. Fifty-nine studies (36%) examined correlates or consequences of co-use. Factors consistently associated with increased likelihood of co-use, defined as significant associations in at least four studies, were African-American ethnicity, mental and physical health characteristics (e.g., high-intensity pleasure temperament), and school characteristics (e.g., good grades). The only consistent consequence of co-use was exacerbation of mental health symptoms. Few studies examined prevention (n = 3) or cessation (n = 2) interventions for TOB and MJ co-use, and the findings were stronger for prevention efforts. A sufficient literature base has documented that TOB and MJ use are strongly related in young people, yet few consistent correlates and consequences of co-use have been identified to inform intervention targets. PMID:22245559
Bortoluzzi, Marcelo Carlos; Kehrig, Ruth Terezinha; Loguercio, Alessandro Dourado; Traebert, Jefferson Luiz
The tobacco consumption has been pointed as an epidemic and the prevention to the smoking habit is indicated as high priority for the public health of the nations. This is an observational cross-sectional study comprising a representative sample of an adult population in a Southern Brazilian city aiming to know the tobacco consumption prevalence and the profile of the smoker. Smokers' prevalence was 17.3% and female subjects were 54.9% of the sample. Smoking occurred predominantly in subjects with age older than 39 years (p<0.001), with less than eight years of education (p<0.001), with moderate and severe scores of depression measured by Beck Depression Inventory (p=0.001) and low familiar income (p=0,029). The district shows high prevalence of smokers which are predominantly subjects older than 39 years, with low income and education. This study also showed an association with moderate or severe depression and the smoking habit.
Sussman, Steve; McCuller, William J; Zheng, Hong; Pfingston, Yvonne M; Miyano, James; Dent, Clyde W
This paper presents the Project EX research program. The historical background for Project EX is presented, including a brief summary of reasons youth fail to quit tobacco use, the disappointing status of previous cessation research, and the teen cessation trial that provided the template for the current project (Project TNT). Next, program development studies for Project EX are described. Through use of focus groups, a theme study (concept evaluation of written activity descriptions), a component study, and pilot studies, an eight-session program was developed. This program involves novel activities (e.g., "talk show enactments," games, and alternative medicine-type activities such as yoga and meditation) in combination with motivation enhancement and cognitive-behavioral strategies to motivate and instruct in cessation initiation and maintenance efforts. The outcomes of the first experimental trial of Project EX, a school-based clinic program, are described, followed by a posthoc analysis of its effects mediation. A second EX study, a multiple baseline single group pilot study design in Wuhan, China, is described next. Description of a second experimental trial follows, which tested EX with nicotine gum versus a natural herb. A third experimental trial that tests a classroom prevention/cessation version of EX is then introduced. Finally, the implications of this work are discussed. The intent-to-treat quit rate for Project EX is approximately 15% across studies, double that of a standard care comparison. Effects last up to a six-month post-program at regular and alternative high schools. Through a systematic protocol of empirical program development and field trials, an effective and replicable model teen tobacco use cessation program is established. Future cessation work might expand on this work.
Sussman, Steve; McCuller, William J; Zheng, Hong; Pfingston, Yvonne M; Miyano, James; Dent, Clyde W
This paper presents the Project EX research program. The historical background for Project EX is presented, including a brief summary of reasons youth fail to quit tobacco use, the disappointing status of previous cessation research, and the teen cessation trial that provided the template for the current project (Project TNT). Next, program development studies for Project EX are described. Through use of focus groups, a theme study (concept evaluation of written activity descriptions), a component study, and pilot studies, an eight-session program was developed. This program involves novel activities (e.g., "talk show enactments," games, and alternative medicine-type activities such as yoga and meditation) in combination with motivation enhancement and cognitive-behavioral strategies to motivate and instruct in cessation initiation and maintenance efforts. The outcomes of the first experimental trial of Project EX, a school-based clinic program, are described, followed by a posthoc analysis of its effects mediation. A second EX study, a multiple baseline single group pilot study design in Wuhan, China, is described next. Description of a second experimental trial follows, which tested EX with nicotine gum versus a natural herb. A third experimental trial that tests a classroom prevention/cessation version of EX is then introduced. Finally, the implications of this work are discussed. The intent-to-treat quit rate for Project EX is approximately 15% across studies, double that of a standard care comparison. Effects last up to a six-month post-program at regular and alternative high schools. Through a systematic protocol of empirical program development and field trials, an effective and replicable model teen tobacco use cessation program is established. Future cessation work might expand on this work.
Sussman, Steve; McCuller, William J; Zheng, Hong; Pfingston, Yvonne M; Miyano, James; Dent, Clyde W
This paper presents the Project EX research program. The historical background for Project EX is presented, including a brief summary of reasons youth fail to quit tobacco use, the disappointing status of previous cessation research, and the teen cessation trial that provided the template for the current project (Project TNT). Next, program development studies for Project EX are described. Through use of focus groups, a theme study (concept evaluation of written activity descriptions), a component study, and pilot studies, an eight-session program was developed. This program involves novel activities (e.g., "talk show enactments," games, and alternative medicine-type activities such as yoga and meditation) in combination with motivation enhancement and cognitive-behavioral strategies to motivate and instruct in cessation initiation and maintenance efforts. The outcomes of the first experimental trial of Project EX, a school-based clinic program, are described, followed by a posthoc analysis of its effects mediation. A second EX study, a multiple baseline single group pilot study design in Wuhan, China, is described next. Description of a second experimental trial follows, which tested EX with nicotine gum versus a natural herb. A third experimental trial that tests a classroom prevention/cessation version of EX is then introduced. Finally, the implications of this work are discussed. The intent-to-treat quit rate for Project EX is approximately 15% across studies, double that of a standard care comparison. Effects last up to a six-month post-program at regular and alternative high schools. Through a systematic protocol of empirical program development and field trials, an effective and replicable model teen tobacco use cessation program is established. Future cessation work might expand on this work. PMID:19570278
Anokhin, Andrey P.; Golosheykin, Simon
Inhibitory deficits have been widely reported and substance abuse, however, it remains unclear whether such deficits represent a determinant or a consequence of substance use. Here we show, using a prospective longitudinal design, that developmental abnormalities in the neural correlates of response inhibition in adolescents increase the risk for subsequent cigarette smoking. Reduced No-Go P3 amplitude, delayed latency of Go P3 peak, and reduced synchrony of neuronal oscillations at age 14 prospectively predicted regular smoking at age 18. The present findings suggest that functional brain correlates of response inhibition represent a developmental marker of risk for future substance abuse. PMID:27392089
Introduction: Finding ways to discourage adolescents from taking up smoking is important because those who begin smoking at an earlier age are more likely to become addicted and have greater difficulty in quitting. This article examined whether anti smoking messages and education could help to reduce smoking susceptibility among adolescents in two Southeast Asian countries and to explore the possible moderating effect of country and gender. Methods: Data came from Wave 1 of the International Tobacco Control Southeast Asia Project (ITC-SEA) survey conducted in Malaysia (n = 1,008) and Thailand (n = 1,000) where adolescents were asked about receiving antismoking advice from nurses or doctors, being taught at schools about the danger of smoking, noticing antismoking messages, knowledge of health effects of smoking, beliefs about the health risks of smoking, smoking susceptibility, and demographic information. Data were analyzed using chi-square tests and logistic regression models. Results: Overall, significantly more Thai adolescents reported receiving advice from their nurses or doctors about the danger of smoking (p < .001), but no country difference was observed for reported antismoking education in schools and exposure to antismoking messages. Multivariate analyses revealed that only provision of antismoking education at schools was significantly associated with reduced susceptibility to smoking among female Malaysian adolescents (OR = 0.26). Higher knowledge of smoking harm and higher perceived health risk of smoking were associated with reduced smoking susceptibility among Thai female (OR = 0.52) and Malaysian male adolescents (OR = 0.63), respectively. Conclusions: Educating adolescents about the dangers of smoking in schools appears to be the most effective means of reducing adolescents’ smoking susceptibility in both countries, although different prevention strategies may be necessary to ensure effectiveness for male and female adolescents. PMID:22949569
Becker, Sara J; Midoun, Miriam M; Zeithaml, Valarie A; Clark, Melissa A; Spirito, Anthony
Professional psychologists are increasingly encouraged to document and evaluate the quality of the treatment they provide. However, there is a significant gap in knowledge about the extent to which extant definitions of treatment quality converge with patient perceptions. The primary goal of this study was to examine how adolescent substance users (ASU) and their caregivers perceive treatment quality. The secondary goal was to determine how these perceptions align with expert-derived definitions of ASU treatment quality and dimensions of perceived quality used frequently in other service disciplines. Focus groups and individual interviews were conducted with 24 ASU and 29 caregivers to explore how participants conceptualize a quality treatment experience. Content analysis identified three major dimensions of perceived treatment quality, each of which contained three sub-dimensions: Therapeutic Relationship (i.e., Acceptance, Caring, Connection), Provider Characteristics (i.e., Experience, Communication Skills, Accessibility), and Treatment Approach (i.e., Integrated Care, Use of Structure, and Parent Involvement). Results revealed modest convergence between patient perceptions and existing definitions of quality, with several meaningful discrepancies. Most notably, the Therapeutic Relationship was the most important dimension to ASU and their caregivers, while expert-derived definitions emphasized the Treatment Approach. Implications for practicing psychologists to enhance training and supervision, quality improvement, and health education initiatives are discussed.
Becker, Sara J.; Midoun, Miriam M.; Zeithaml, Valarie A.; Clark, Melissa A.; Spirito, Anthony
Professional psychologists are increasingly encouraged to document and evaluate the quality of the treatment they provide. However, there is a significant gap in knowledge about the extent to which extant definitions of treatment quality converge with patient perceptions. The primary goal of this study was to examine how adolescent substance users (ASU) and their caregivers perceive treatment quality. The secondary goal was to determine how these perceptions align with expert-derived definitions of ASU treatment quality and dimensions of perceived quality used frequently in other service disciplines. Focus groups and individual interviews were conducted with 24 ASU and 29 caregivers to explore how participants conceptualize a quality treatment experience. Content analysis identified three major dimensions of perceived treatment quality, each of which contained three sub-dimensions: Therapeutic Relationship (i.e., Acceptance, Caring, Connection), Provider Characteristics (i.e., Experience, Communication Skills, Accessibility), and Treatment Approach (i.e., Integrated Care, Use of Structure, and Parent Involvement). Results revealed modest convergence between patient perceptions and existing definitions of quality, with several meaningful discrepancies. Most notably, the Therapeutic Relationship was the most important dimension to ASU and their caregivers, while expert-derived definitions emphasized the Treatment Approach. Implications for practicing psychologists to enhance training and supervision, quality improvement, and health education initiatives are discussed. PMID:27524856
Nuno-Gutierrez, Bertha Lidia; Alvarez-Nemegyei, Jose; Rodriguez-Cerda, Oscar
The aim of this study was to explore the social representations used by the parents of adolescent drug users to explain the onset of drug use. Differences in explanations between the parents of male and female adolescents were also explored. Sixty parents who accompanied their children to four rehabilitation centers in 2004 completed two…
The Food and Drug Administration (FDA) is reissuing a final rule restricting the sale, distribution, and use of cigarettes and smokeless tobacco. As required by the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act), FDA is issuing a final rule that is identical to the provisions of the final rule on cigarettes and smokeless tobacco published by FDA in 1996, with certain required exceptions. The rule prohibits the sale of cigarettes and smokeless tobacco to individuals under the age of 18 and imposes specific marketing, labeling, and advertising requirements. Elsewhere in this issue of the Federal Register, FDA is issuing an advance notice of proposed rulemaking to obtain information related to the regulation of outdoor advertising of cigarettes and smokeless tobacco.
Wisconsin Clearinghouse, Madison.
This booklet presents, in comic book format, information for children and adolescents on the hazards of using smokeless tobacco. It touches on the use of smokeless tobacco by baseball players, the advertising of smokeless tobacco, and the illegality of selling smokeless tobacco to minors. Health consequences of using smokeless tobacco, including…
Robinson, Elizabeth J.; Davidson, Lisa S.; Uchanski, Rosalie M.; Brenner, Christine M.; Geers, Ann E.
Background For pediatric cochlear implant (CI) users, CI processor technology, map characteristics and fitting strategies are known to have a substantial impact on speech perception scores at young ages. It is unknown whether these benefits continue over time as these children reach adolescence. Purpose To document changes in CI technology, map characteristics, and speech perception scores in children between elementary grades and high school, and to describe relations between map characteristics and speech perception scores over time. Research Design A longitudinal design with participants 8–9 years old at session 1 and 15–18 years old at session 2. Study Sample Participants were 82 adolescents with unilateral CIs, who are a subset of a larger longitudinal study. Mean age at implantation was 3.4 years (range: 1.7 – 5.4), and mean duration of device use was 5.5 years (range: 3.8–7.5) at session 1 and 13.3 years (range: 10.9–15) at session 2. Data Collection and Analysis Speech perception tests at sessions 1 and 2 were the Lexical Neighborhood word Test (LNT-70) and Bamford-Kowal-Bench sentences in quiet (BKB-Q), presented at 70 dB SPL. At session 2, the LNT was also administered at 50 dB SPL (LNT-50) and BKB sentences were administered in noise with a +10 dB SNR (BKB-N). CI processor technology type and CI map characteristics (coding strategy, number of electrodes, map threshold levels [T levels], and map comfort levels [C levels]) were obtained at both sessions. Electrical dynamic range [EDR] was computed [C level – T level], and descriptive statistics, correlations, and repeated-measures ANOVAs were employed. Results Participants achieved significantly higher LNT and BKB scores, at 70 dB SPL, at ages 15-18 than at ages 8-9 years. Forty-two participants had 1-3 electrodes either activated or deactivated in their map between test sessions, and 40 had no change in number of active electrodes (mean change: -0.5; range: -3 to +2). After conversion from
Stigler, Melissa Harrell; Perry, Cheryl L.; Smolenski, Derek; Arora, Monika; Reddy, K. Srinath
This article presents the results of a mediation analysis of Project MYTRI (Mobilizing Youth for Tobacco Related Initiatives in India), a randomized, controlled trial of a multiple-component, school-based tobacco prevention program for sixth- to ninth-graders (n = 14,085) in Delhi and Chennai, India. A mediation analysis identifies "how"…
Gassman, Ruth; Nowicke, Carole E.; Jun, Mi Kung
Survey responses by nonexperimental drug users in grades 6-12 were examined to determine whether MA users and nonusers with shared individual characteristics experience differential rates of police trouble, and whether specific factors place some users at greater risk than others. Findings showed that police trouble is pronounced for MA users,…
Kelishadi, Roya; Shahsanai, Armindokht; Qorbani, Mostafa; Esmaeil Motlagh, Mohammad; Jari, Mohsen; Ardalan, Gelayol; Ansari, Hossein; Asayesh, Hamid; Heshmat, Ramin
Background Iran is facing an epidemiologic transition, with one of its features being the tendency towards smoking by adolescents. The findings of previous studies in Iran have shown that the pervasiveness of tobacco products among school students is high. No previous study has reported the prevalence and determinants of smoking in various socioeconomic statuses (SESs) and at the subnational level in Iran. Objectives To compare the prevalence of smoking and the factors that influence the initiation and continuation of tobacco use in a nationally representative sample of Iranian adolescents living in different regions with diverse socio-demographic patterns. Patients and Methods This nationwide, cross-sectional study was conducted in 2011 - 2012 among 14,880 students, aged 6 - 18 years, selected by cluster sampling from 30 provinces. Anonymous questionnaires were completed about tobacco use and the main psychological determinants of initiation and continuation to smoke. The questionnaire was modeled on the world health organization global school-based student health survey (WHO-GSHS). The sub-national regions were defined by the criteria of geography combined with SES. According to this classification, the lowest to highest SESs were considered for the southeast, north-northeast, west, and central regions, respectively. Data were analyzed using the STATA statistical software package. Results Overall, 13,486 students completed this survey (participation rate of 90.6%). They consisted of 50.8% boys, 75.6% urban residents, with a mean age of 12.47 ± 3.36 years. According to the self-report of students, 2.6 % (3.5% of boys and 1.7% of girls) were current smokers, and5.9% (7.5% of boys and 4.2% of girls) had ever been smokers. The current use of tobacco was higher in participants aged 14 - 18 years (6.11%) than in those aged 10 - 13.9 years (1.18%) and 6 - 9.9 years (0.51%). Current and past tobacco use, respectively, had the lowest prevalence in the region with the
Bogart, Laura M.; Collins, Rebecca L.; Ellickson, Phyllis L.; Klein, David J.
The present study investigated whether adolescent cigarette, alcohol, marijuana, and hard drug use predicts life satisfaction in young adulthood. Survey data were used from a longitudinal cohort of 2376 adolescents at ages 18 and 29, originally recruited from California and Oregon middle schools at age 13. Results of multivariate models indicated…
Vaughn, Courtney; Long, Wesley
Investigates the uniqueness and complexity of adolescent drug and alcohol abuse recovery, particularly the early years and events catalyzing the surrender process. Offers individual interviews of seven adolescents who surrendered their alcohol and drug addictions and constructed sober identities through participation in Alcoholics Anonymous. (GCP)
Walker, Denise D.; Roffman, Roger A.; Stephens, Robert S.; Wakana, Kim; Berghuis, James
This study's aims were (a) to investigate the feasibility of a school-based motivational enhancement therapy (MET) intervention in voluntarily attracting adolescents who smoke marijuana regularly but who are not seeking formal treatment and (b) to evaluate the efficacy of the intervention in reducing marijuana use. Ninety-seven adolescents who had…
Hamilton, Nancy L.; Brantley, Laura Bunch; Tims, Frank M.; Angelovich, Nancy; McDougall, Barbara
Substance-abusing adolescents experiencing inadequate family structure and functioning will be at a serious disadvantage with regard to recovery. The family support network (FSN) intervention seeks to extend the focus of treatment beyond the world of the adolescent by engaging the family, a major system in his or her life. Designed to increase…
Brinson, Jesse A.
Examined African-American adolescents' use of alcohol and their perceptions of their family environments. Alcohol-using adolescents (n=71) completed Family Environment Scale (FES). Analyses of data revealed that females differed significantly from males on 4 of 10 FES subscales. Findings support view that alcohol affects perception of family…
Farber, Harold J; Nelson, Kevin E; Groner, Judith A; Walley, Susan C
Tobacco use and tobacco smoke exposure are among the most important health threats to children, adolescents, and adults. There is no safe level of tobacco smoke exposure. The developing brains of children and adolescents are particularly vulnerable to the development of tobacco and nicotine dependence. Tobacco is unique among consumer products in that it causes disease and death when used exactly as intended. Tobacco continues to be heavily promoted to children and young adults. Flavored and alternative tobacco products, including little cigars, chewing tobacco, and electronic nicotine delivery systems are gaining popularity among youth. This statement describes important evidence-based public policy actions that, when implemented, will reduce tobacco product use and tobacco smoke exposure among youth and, by doing so, improve the health of children and young adults.
Charlesworth, Annemarie; Glantz, Stanton A
Despite the tobacco industry's voluntary restrictions and its agreement with the state attorneys general prohibiting direct and indirect cigarette marketing to youth and paid product placement, tobacco use remains prevalent in movies. Extensive research provides strong and consistent evidence that smoking in the movies promotes smoking. This article summarizes the evidence on the nature and effect of smoking in the movies on adolescents (and others) and proposes several solutions to reduce adolescent exposure to movie smoking and subsequent smoking.
Thrasher, James F.; Jackson, Christine
Campaigns to prevent adolescent smoking increasingly depict the tobacco industry as deceitful and exploitative. This study was undertaken to determine how adolescents' expectations about the trustworthiness of companies, in general, influence the pathway through which anti-tobacco industry campaigns prevent smoking. Structural equation modeling…
Valdés-Salgado, Raydel; Reynales-Shiguematsu, Luz Myriam; Lazcano-Ponce, Eduardo C; Hernández-Avila, Mauricio
Smoking prevention efforts should either prevent target groups from becoming susceptible to smoking or prevent susceptible adolescents from progressing to becoming regular smokers. To describe the prevalence of susceptibility to smoking among never smoker students from cities that applied the GYTS in 2003 and 2006. The GYTS uses a two-stage cluster sample survey design that produces representative samples of students aged 12–15 years enrolled in public, private, and technical schools. The survey was undertaken at 399 schools in 9 cities. The GYTS surveyed 33,297 students during the academic years 2003–04 and 2006–07. Among never smokers, about 25% are likely to initiate smoking in the next 12 months. There are no differences in susceptibility to smoking by gender. When comparing results from 2003 and 2006, the susceptibility index has not changed, but for one city. The GYTS results are useful for monitoring susceptibility to smoking among adolescents and provide evidence for strengthening the efforts of tobacco control programs in Mexico. PMID:19440444
Batalla, Albert; Bhattacharyya, Sagnik; Yücel, Murat; Fusar-Poli, Paolo; Crippa, Jose Alexandre; Nogué, Santiago; Torrens, Marta; Pujol, Jesús; Farré, Magí; Martin-Santos, Rocio
Background The growing concern about cannabis use, the most commonly used illicit drug worldwide, has led to a significant increase in the number of human studies using neuroimaging techniques to determine the effect of cannabis on brain structure and function. We conducted a systematic review to assess the evidence of the impact of chronic cannabis use on brain structure and function in adults and adolescents. Methods Papers published until August 2012 were included from EMBASE, Medline, PubMed and LILACS databases following a comprehensive search strategy and pre-determined set of criteria for article selection. Only neuroimaging studies involving chronic cannabis users with a matched control group were considered. Results One hundred and forty-two studies were identified, of which 43 met the established criteria. Eight studies were in adolescent population. Neuroimaging studies provide evidence of morphological brain alterations in both population groups, particularly in the medial temporal and frontal cortices, as well as the cerebellum. These effects may be related to the amount of cannabis exposure. Functional neuroimaging studies suggest different patterns of resting global and brain activity during the performance of several cognitive tasks both in adolescents and adults, which may indicate compensatory effects in response to chronic cannabis exposure. Limitations However, the results pointed out methodological limitations of the work conducted to date and considerable heterogeneity in the findings. Conclusion Chronic cannabis use may alter brain structure and function in adult and adolescent population. Further studies should consider the use of convergent methodology, prospective large samples involving adolescent to adulthood subjects, and data-sharing initiatives. PMID:23390554
Arain, Sadaf S; Kazi, Tasneem G; Arain, Asma J; Afridi, Hassan I; Brahman, Kapil D; Naeemullah; Ali, Jamshed; Memon, G Zuhra
The present study was aimed to evaluate the cadmium (Cd) and lead (Pb) levels in the scalp hair samples of adolescent boys age ranged 12-15 years, chewing different smokeless tobacco (SLT) products. For comparative purpose, boys of the same age group who did not consume any SLT products were selected as referents. The concentrations of Cd and Pb in SLT products and the scalp hair samples were measured by electrothermal atomic absorption spectrophotometer (ETAAS) after microwave-assisted acid digestion. The validity and accuracy of the methodology were checked by certified reference materials (CRMs). The difference between experimental and certified values of both elements was not significant (p > 0.05). The resulted data indicated that the adolescent boys who consumed different SLT products have two- to threefold higher levels of Cd and Pb in the scalp hair samples as compared to the referent boys (p < 0.01). The adolescent chewing different SLT products have 82.2-110 and 60.6-94.5% higher levels of Cd and Pb, respectively, in their scalp hair as related to the referents.
Wiium, Nora; Aarø, Leif E
In this study, measures of outcome expectancies related to use of snus (wet snuff) were used to predict reported frequency of snus use. Data stem from a nation-wide survey in Norway among 16- to 20-year-olds. Only users of snus were included in the statistical analyses (n = 589). The main outcome measure, frequency of snus use, was measured as a categorical variable - occasional, weekly and daily use. Four dimensions of outcome expectancies (mood regulation, smoking control, weight control and negative health outcomes) were measured and confirmed in a confirmatory factor analysis. Informants tended to believe that snus use is harmful to health, but still they supported the idea of snus as a way to control own cigarette smoking. In a SEM model, two of the four dimensions of outcome expectancies turned out to be particularly significant predictors of frequency of snus use - mood regulation and smoking control. No significant interactions with gender were found. Males scored higher than females on "mood regulation", and "smoking control", while females scored higher than males on "negative health outcomes". If more smokers were convinced that snus use is a less harmful alternative, more of them might start using snus, not only because there is some association between health outcome expectancies and snus use, but also because snus use by many is perceived as a remedy to stop smoking and as a way to gain some of the mood regulation benefits which are usually associated with smoking.
... stillbirth when used during pregnancy Smokeless tobacco can lead to nicotine poisoning and even death in children who mistake it for candy. Smokeless tobacco causes nicotine addiction. This can lead to smoking and using other forms of tobacco. ...
Background Diverse psychosocial factors have been associated with the use of cigarettes by adolescents. We investigated gender differences in tobacco smoking, and factors correlated with smoking among boys and girls. Methods Data was collected on recent cigarette smoking (CS) and related factors, with a focus on religious beliefs, leisure activities, family structure, relationships and parental monitoring from 2,691 private school-attending youths from 28 schools in São Paulo, Brazil, selected via probability sampling. Estimates were derived via weighted hierarchical logistic regression models. Results There was no difference in the prevalence of recent cigarette smoking between boys and girls (14.2%). Older age (aORboys = 1.71[1.33-2.21]; aORgirls = 1.73[1.35-2.23]), second-hand smoke exposure at home (aORboys = 1.52[1.00-2.29]; aORgirls = 1.74[1.13-2.68]) and not having a religion (aORboys = 1.99[1.41-2.81]; aORgirls = 1.78[1.14-2.78]) were associated with CS in boys and girls. Adolescents who went out often at night were more likely to be tobacco smokers (aORboys = 8.82[3.96-19.67]; aORgirls = 14.20[6.64-30.37]). For girls, data suggest that CS was also associated with a lack of parental attention and care (aORgirls = 4.37[1.19-16.04]) and no participation in youth religious activities (aORgirls = 2.76[1.49-5.12]). For boys, CS was additionally associated with the loss of one or both parents (aORboys = 3.75[1.78-7.85]). Conclusions Although older age, living with smokers at home and lack of religion were common contributing factors to cigarette smoking among all adolescents, girls were influenced to a greater degree by family relationships and religiosity than boys. The study results may be materially important to the development of prevention programs that influence determinants connected to gender and the implementation of single-core models of prevention; gender differences must be considered in order to reduce adolescent CS. PMID:21129177
Svedin, Carl Goran; Akerman, Ingrid; Priebe, Gisela
Frequent use of pornography has not been sufficiently studied before. In a Swedish survey 2015 male students aged 18 years participated. A group of frequent users of pornography (N = 200, 10.5%) were studied with respect to background and psychosocial correlates. The frequent users had a more positive attitude to pornography, were more often…
Cohen, R Y; Sattler, J; Felix, M R; Brownell, K D
Experimentation with both cigarettes and smokeless tobacco by children in grades 3-12 in a school district in Pennsylvania was related to peer experimentation, parental use, and personal beliefs about the harm of the product for both males and females. Experimentation with both products had begun as early as the third grade and increased with age, with a major increase in experimentation during junior high school. Nearly half the males in grades 7-12 did not believe smokeless tobacco was harmful. PMID:3661802
Epstein, Katherine A; Kumra, Sanjiv
During late adolescence, progressive cortical thinning occurs in heteromodal association cortex (HASC) that is thought to subserve cognitive development. However, the impact of cannabis use disorder (CUD) upon cortical gray matter development in both healthy adolescents and adolescents with early-onset schizophrenia (EOS) is unclear. T1-weighted magnetic resonance images were acquired from 79 adolescents at baseline and after an 18-month follow-up: 17 with EOS, 17 with CUD, 11 with EOS+CUD, and 34 healthy controls (HC). Mean age at baseline was 16.4years (CUD+) and 17.0years (CUD-). Using FreeSurfer, measures of cortical thickness for ROIs within HASC were obtained. A 2 (EOS versus no EOS)×2 (CUD versus no CUD) multivariate analysis of covariance was applied to change scores from baseline to follow-up to test for main effects of EOS and CUD and an interaction effect. After adjusting for covariates, a significant main effect of CUD was observed. Adolescents with CUD showed an attenuated loss of cortical thickness in the left and right supramarginal, left and right inferior parietal, right pars triangularis, left pars opercularis, left superior frontal, and left superior temporal regions compared to non-using subjects. Stepwise linear regression analysis indicated that greater cumulative cannabis exposure predicted greater cortical thickness in both the left (p=.008) and right (p=.04) superior frontal gyri at study endpoint after adjusting for baseline cortical thickness for the entire sample. These preliminary longitudinal data demonstrate an atypical pattern of cortical development in HASC in adolescents with CUD relative to non-using subjects, across diagnostic groups. Additional studies are needed to replicate these data and to clarify the clinical significance of these findings.
Mason, Michael; Light, John; Campbell, Leah; Keyser-Marcus, Lori; Crewe, Stephanie; Way, Thomas; Saunders, Heather; King, Laura; Zaharakis, Nikola M; McHenry, Chantal
Close peer networks can affect adolescents' health behaviors by altering their social environments, and thus their risk for and protection against substance use involvement. We tested a 20 minute intervention named Peer Network Counseling that integrates motivational interviewing and peer network strategies with 119 urban adolescents who reported occasional or problem substance use. Adolescents presenting at primary care clinic were randomized to intervention or control conditions and followed for 6 months. Mixed-effect latent growth models were used to evaluate intervention effects on trajectories of alcohol and marijuana use, offers to use substances, and moderation models to test for interactions between intervention condition and peer network characteristics. A significant intervention effect was found for boys for offers to use alcohol from friends (p<.05), along with a trend significant effect for alcohol use (p<.08). Intervention was more effective in reducing marijuana use, vs. control, for participants with more peer social support (p<.001) and with more peer encouragement for prosocial behavior (school, clubs, sports, religious activities); however, intervention did not affect these network characteristics. Results provide support to continue this line of research to test brief interventions that activate protective peer network characteristics among at-risk adolescents, while also raising some interesting gender-based intervention questions for future research.
Tait, Robert J.; Hulse, Gary K.
The objectives were, firstly, to describe the frequency and type of hospital emergency department (ED) admissions in a small number of alcohol and other drug (AOD) using adolescents who accounted for a high number of ED and other hospital presentations. Secondly, to identify interventions that impacted on these repeat ED presentations. An earlier…
Gallagher, Jen; Schlösser, Annette
Ten per cent of young people experience mental health difficulties at any one time. Prevention and early intervention leads to better prognosis for young people's mental well-being in the short and long term. Child and Adolescent Mental Health Services (CAMHS) must be able to provide swift and effective interventions for a range of difficulties to…
Berk, Lotte; Stewart, Jennifer L.; May, April C.; Wiers, Reinout W.; Davenport, Paul W.; Paulus, Martin P.; Tapert, Susan F.
Background and Aims Adolescents with substance use disorders (SUD) exhibit hyposensitivity to pleasant internally generated (interoceptive) stimuli and hypersensitivity to external rewarding stimuli. It is unclear whether similar patterns exist for aversive interoceptive stimuli. We compared activation in the insular cortex and other brain regions during the anticipation and experience of aversive stimuli between adolescents with SUD and those without. Design and participants Cross-sectional experimental study with two groups: Adolescents (ages 15–17) with an alcohol or marijuana SUD (n=18) and healthy comparison subjects (CON, n=15). Participants were recruited by distributing flyers at local high schools. Setting Keck Imaging Center, University of California San Diego, USA. Measurements Behavioral and neural responses to a continuous performance task with inspiratory breathing load recorded during an fMRI session. Questionnaires assessed lifetime drug use, anxiety, sensation seeking, impulsivity, affect, and bodily awareness. Visual analogue scales assessed drug craving and breathing load responses. Findings Across subjects, experience of breathing load elicited greater bilateral anterior and posterior insula (AI and PI, respectively) activation than anticipation (F(1,31)=4.16, p<.05). SUD exhibited greater left AI and bilateral PI activation during breathing load than anticipation, compared with CON (F(1,31)=4.16, p<.05). In contrast, CON showed greater activation during anticipation than breathing load in left PI, compared with SUD (F(1,31)=4.16, p<.05). Conclusions Adolescents with alcohol and marijuana substance use disorders may be hypersensitive to aversive interoceptive stimuli. PMID:26234745
Analysis of data on 1,121 older adolescents and young adults from a national longitudinal survey examined effects of community involvement, social satisfaction, social network size, race, gender, and age on use of alcohol, marijuana, and cocaine. Social support did influence use of alcohol and other drugs, but the direction of influence varied by…
Akre, Christina; Michaud, Pierre-Andre; Berchtold, Andre; Suris, Joan-Carles
The purpose of this article is to identify tobacco and cannabis co-consumptions and consumers' perceptions of each substance. A qualitative research including 22 youths (14 males) aged 15-21 years in seven individual interviews and five focus groups. Discussions were recorded, transcribed verbatim and transferred to Atlas.ti software for narrative…
Leve, Leslie D.; Harold, Gordon T.; Van Ryzin, Mark J.; Elam, Kit; Chamberlain, Patricia
Associations between trajectories of depressive symptoms and subsequent tobacco and alcohol use were examined in two samples of girls assessed at age 11.5 (T1), 12.5 (T2), and 13.5 (T3). Two samples were examined to ascertain if there was generalizability of processes across risk levels and cultures. Study 1 comprised a United States-based sample…
Hanson, Carl L.; Novilla, M. Lelinneth L. B.; Barnes, Michael D.; Eggett, Dennis; McKell, Chelsea; Reichman, Peter; Havens, Mike
The purpose of the study was to compare 30-day prevalence of alcohol, tobacco, and other drug use among twelfth-grade students in Montana across a rural-urban continuum during 2000, 2002, and 2004. The methods include an analysis of the Montana Prevention Needs Assessment (N = 15,372) using multivariable logistic regression adjusting for risk…
Morello, Paola; Pérez, Adriana; Peña, Lorena; Braun, Sandra N; Kollath-Cattano, Christy; Thrasher, James F; Sargent, James; Mejía, Raúl
Tobacco, alcohol and drug use starts at an early age. It is important to identify risk factors associated with initiation. In 2014, a survey was conducted among students attending first year of secondary schools in Buenos Aires, Córdoba, and Tucumán. A total of 3172 students completed the survey (42% were girls); their mean age was 12.8 years old. Findings showed that 10% had smoked; 32% had consumed alcohol; 17% had a heavy drinking episode in the past month; and 8% had used at least one illegal drug once in their lifetime. A high sensation seeking index was associated with the use of tobacco (odds ratio [OR]: 4.25, 95% confidence interval [CI]: 2.2-8.1), alcohol (OR: 5.56, 95% CI: 3.73-8.31), and marijuana, coca paste or cocaine, (OR: 11.73, 95% CI: 5.81-23.69). Having friends who smoke or drink was associated with tobacco (OR: 12.6, 95% CI: 7.8-20.5) and alcohol use (OR: 5.17, 95% CI: 4.15-6.40). Having permissive parents in terms of media use was associated with tobacco use (OR: 3.7, 95% CI: 2.1-6.5), and perceiving a low parental support and control (OR: 3.02, 95% CI: 1.40-6.52) was associated with marijuana, coca paste and cocaine use.
Bansal-Travers, Maansi; Fong, Geoffrey T; Quah, Anne C K; Sansone, Genevieve; Pednekar, Mangesh S; Gupta, Prakash C; Sinha, Dhirendra N
Tobacco companies are utilizing similar strategies to advertise and promote their products in developing countries as they have used successfully for over 50 years in developed countries. The present study describes how adult smokers, smokeless tobacco users, and non-users of tobacco from the Tobacco Control Project (TCP) India Pilot Survey, conducted in 2006, responded to questions regarding their perceptions and observations of pro-tobacco advertising and promotion and beliefs about tobacco use. Analyses found that 74% (n=562) of respondents reported seeing some form of pro-tobacco advertising in the last six months, with no differences observed between smokers (74%), smokeless tobacco users (74%), and nonsmokers (73%). More than half of respondents reported seeing pro-tobacco advertising on store windows or inside shops. Overall, this study found that a significant percentage of tobacco users and non-users in India report seeing some form of pro-tobacco advertising and promotion messages. Additional analyses found that smokers were more likely to perceive tobacco use as harmful to their health compared with smokeless tobacco users and non-users (p<0.01). The findings from this study reiterate the need for stronger legislation and strict enforcement of bans on direct and indirect advertising and promotion of tobacco products in India.
Bansal-Travers, Maansi; Fong, Geoffrey T.; Quah, Anne C.K.; Sansone, Genevieve; Pednekar, Mangesh S.; Gupta, Prakash C.; Sinha, Dhirendra N.
Tobacco companies are utilizing similar strategies to advertise and promote their products in developing countries as they have used successfully for over 50 years in developed countries. The present study describes how adult smokers, smokeless tobacco users, and non-users of tobacco from the Tobacco Control Project (TCP) India Pilot Survey, conducted in 2006, responded to questions regarding their perceptions and observations of pro-tobacco advertising and promotion and beliefs about tobacco use. Analyses found that 74% (n=562) of respondents reported seeing some form of pro-tobacco advertising in the last six months, with no differences observed between smokers (74%), smokeless tobacco users (74%), and nonsmokers (73%). More than half of respondents reported seeing pro-tobacco advertising on store windows or inside shops. Overall, this study found that a significant percentage of tobacco users and non-users in India report seeing some form of pro-tobacco advertising and promotion messages. Additional analyses found that smokers were more likely to perceive tobacco use as harmful to their health compared with smokeless tobacco users and non-users (p<0.01). The findings from this study reiterate the need for stronger legislation and strict enforcement of bans on direct and indirect advertising and promotion of tobacco products in India. PMID:25455648
Garcia, Grey Yuliet Ceballos; Santos, Darci Neves; Machado, Daiane Borges
Few Brazilian studies have addressed the use of mental health services for children and adolescents. This study aimed to characterize the national distribution of Psychosocial Care Centers for Children and Adolescents (CAPSi) and describe the patient profile in this age group between 2008 and 2012. An ecological study was carried out, using records from the Authorizations for High-Complexity Procedures (APAC) system and the Brazilian National Registry of Healthcare Organizations (CNES). Socio-demographics and disease profile were analyzed. In 2014, 208 CAPSi were recorded in the CNES, distributed across 23 of Brazil's 27 states. Treatments included predominantly behavioral disorders (29.7%), developmental disorders (23.6%), and mental retardation (12.5%). CAPSi are insufficient and unequally distributed. The disease profile suggests the need for linkage between specialized mental health services and primary care, in addition to the inclusion of inter-sector work.
Balhara, Yatan Pal Singh; Verma, Rohit
Web based interventions (WBIs) have been developed for various health conditions. These include interventions for various psychoactive substance use disorders including tobacco and alcohol. Tobacco use has remained the single largest preventable cause of global mortality and morbidity for many years. It is responsible for around 6 million deaths annually world-wide. Ironically, most of the tobacco users reside in resource poor low and middle-income countries. The article reviews the existing literature on WBIs for management of tobacco use. The literature search was performed using MedLine, PubMed, PsycINFO, Embase and Cochrane Review for relevant English language articles published from 1998 up to 2013. There is limited support for effectiveness of WBIs for managing tobacco use among adolescents. Although most of the trials among adults found WBIs to be more effective at short term follow-up (a few days to weeks), the benefits failed to extend beyond 3 months in most of the studies. All but one interventions studied in a randomized controlled trial is for smoking forms.
Pettigrew, Jonathan; Miller-Day, Michelle; Krieger, Janice; Hecht, Michael L.
This study seeks to identify how rural adolescents make health decisions and utilize communication strategies to resist influence attempts in offers of alcohol, tobacco, and other drugs (ATOD). Semi-structured interviews were conducted with 113 adolescents from rural school districts to solicit information on ATOD norms, past ATOD experiences, and substance offer-response episodes. Rural youths’ resistance strategies were similar to previous findings with urban adolescents – refuse, explain, avoid, and leave (the REAL typology) – while unique features of these strategies were identified including the importance of personal narratives, the articulation of a non-user identity, and being “accountable” to self and others. PMID:21552345
Svedin, Carl Göran; Akerman, Ingrid; Priebe, Gisela
Frequent use of pornography has not been sufficiently studied before. In a Swedish survey 2015 male students aged 18 years participated. A group of frequent users of pornography (N = 200, 10.5%) were studied with respect to background and psychosocial correlates. The frequent users had a more positive attitude to pornography, were more often "turned on" viewing pornography and viewed more often advanced forms of pornography. Frequent use was also associated with many problem behaviours. A multiple logistic regression analysis showed that frequent users of pornography were more likely to be living in a large city, consuming alcohol more often, having greater sexual desire and had more often sold sex than other boys of the same age. High frequent viewing of pornography may be seen as a problematic behaviour that needs more attention from both parents and teachers and also to be addressed in clinical interviews.
Singh, Tushar; Arrazola, René A; Corey, Catherine G; Husten, Corinne G; Neff, Linda J; Homa, David M; King, Brian A
Tobacco use is the leading cause of preventable disease and death in the United States; if current smoking rates continue, 5.6 million Americans aged <18 years who are alive today are projected to die prematurely from smoking-related disease. Tobacco use and addiction mostly begin during youth and young adulthood. CDC and the Food and Drug Administration (FDA) analyzed data from the 2011-2015 National Youth Tobacco Surveys (NYTS) to determine the prevalence and trends of current (past 30-day) use of seven tobacco product types (cigarettes, cigars, smokeless tobacco, electronic cigarettes [e-cigarettes], hookahs [water pipes used to smoke tobacco], pipe tobacco, and bidis [small imported cigarettes wrapped in a tendu leaf]) among U.S. middle (grades 6-8) and high (grades 9-12) school students. In 2015, e-cigarettes were the most commonly used tobacco product among middle (5.3%) and high (16.0%) school students. During 2011-2015, significant increases in current use of e-cigarettes and hookahs occurred among middle and high school students, whereas current use of conventional tobacco products, such as cigarettes and cigars decreased, resulting in no change in overall tobacco product use. During 2014-2015, current use of e-cigarettes increased among middle school students, whereas current use of hookahs decreased among high school students; in contrast, no change was observed in use of hookahs among middle school students, use of e-cigarettes among high school students, or use of cigarettes, cigars, smokeless tobacco, pipe tobacco, or bidis among middle and high school students. In 2015, an estimated 4.7 million middle and high school students were current tobacco product users, and, therefore, continue to be exposed to harmful tobacco product constituents, including nicotine. Nicotine exposure during adolescence, a critical period for brain development, can cause addiction, might harm brain development, and could lead to sustained tobacco product use among youths
Smith, Dennis W.; Lee, Jay T.; Colwell, Brian; Stevens-Manser, Stacey
In response to the problem of adolescent smoking and limited appropriate cessation resources, this study examined the pattern and structure of the American Lung Association, Why Do You Smoke? (WDS) to determine its appropriateness for use in youth smoking cessation programs. The WDS is used to help smokers identify primary motivations for using…
Abstract Background Different tobacco and related products, like waterpipe, e-cigarettes, are gaining popularity among adolescents in different countries; the data for Slovenia is currently limited. The purpose of this paper is to present the latest data on the use of different tobacco and related products, with or without flavours, among 15-year old students in Slovenia. Methods Data for 15-year-old students were drawn from 2014 Slovene database of the cross-national survey Health Behaviour in School-Aged Children. The survey sample was selected with stratified two-stage sampling method. The survey was performed in schools with a self-administered web questionnaire. The survey questionnaire included international compulsory, selected optional and national questions, all on a variety of topics related to youth health behaviour. Results 25.2% of 15-year-old students reported current (past 30-day) use of any tobacco related product, mainly cigarettes (93.1% of users), followed by waterpipe (11.7%) and cigars, cigarillos and pipes (9.4%). Exclusive use of unconventional products is low (5.1% of users). 85.5% of users of any product used one product, 48.5% of users used products with flavours. The use of different products, one or more products, and flavoured products was related to gender. Conclusion A comprehensive tobacco control and prevention must address all tobacco and related products. PMID:28289466
Bunge, Eduardo L; Barilá, Carina V; Sánchez, Natalia A; Maglio, Ana L
Client Satisfaction with mental health services is an important aspect in the evaluation of quality of those services. In youth mental health field, a few studies had being made about this characteristic. The aim of this study is to evaluate the relationship between satisfaction of parents, children and adolescents according to sex of patients and therapists. The sample included 382 subjects who attended to Buenos Aires private services who completed the questionnaire of experiences with the service. The results in teenagers' group showed differences in the satisfaction with the service matching the sex of teenagers with the sex of therapist, however in children and parent groups we haven't found significant differences. We discuss the implications of the results in order to improve the services given in youth area.
... divisions about tobacco (including smokeless tobacco), its health effects, and quitting. Related Oral Health Topics Oral Cancer Share This Page Facebook External link – please review our disclaimer Twitter External ...
Aggarwal, Ramesh; Dwivedi, Shridhar
Non communicable diseases in most of the developing countries have surpassed the morbidity and mortality arising from communicable diseases. However there are people who continue to suffer from the residual disabilities of some communicable disease acquired at younger age like polio and develop non communicable diseases like COPD and coronary syndrome at older age primarily because of their tobacco habits. Both of these combination of communicable and non communicable diseases are preventable if timely preventive measures and healthy life style is adopted. This case highlights one such case where patient despite suffering from polio and restrictive lung disease started using tobacco and suffered from obstructive lung disease and coronary syndrome.
Woods, Jennifer L.; Shew, Marcia L.; Tu, Wanzhu; Ofner, Susan; Ott, Mary A.; Fortenberry, J. Dennis
Purpose Imperfect oral contraceptive pill (OCP) regimen adherence may impair contraceptive effectiveness. The purpose of this study was to describe daily adherence patterns of OCP use, to analyze OCP protection on an event level basis, and to examine pill-taking and condom use during method transitions. Methods Women (n = 123, ages 14–17 years) completed quarterly interviews to classify OCP method choice into four categories: stable, initiated, stopped, and discordant use. Within each OCP category, daily diaries were used to assess occurrence of coitus, condom use, and patterns of day-to-day OCP use (i.e., consecutive days of OCP use reported with no more than two consecutive days of nonuse). A coital event was OCP protected if pills were used on both the day of the coitus and the day preceding. Results There were 123 participants who reported at least some OCP use in 210 diary periods (average diary length = 75.5 days). Fifty-three participants categorized as stable users reported 87 diary periods: the average interval of consecutive OCP use in this group was 32.5 days. Among stable users, only 45% of coital events were associated with both OCP and condom use. Over one-fifth of coital events in all groups were protected by no method of contraception. Conclusion Dual use of OCP and barrier contraception remains an elusive goal. The time during OCP adoption or discontinuation is often unprotected by condoms. However, concurrent missed pills and condom nonuse increase pregnancy and infection risk even among stable OCP users. Understanding motivation for method usage may improve education and prevention techniques. PMID:16919800
... of cigarettes and smokeless tobacco. The agency is taking this action in response to a request for an... tobacco products are necessary to protect children and adolescents from the harms caused by tobacco use... adolescents from the harms caused by tobacco use. The agency has received a request for a 90-day extension...
America's leading health organizations agree. Smoking on screen is the No.1 recruiter of new adolescent smokers in the United States - 390,000 kids a year, of whom 120,000 will die from tobacco-caused diseases. That's more Americans than die from drunk driving, criminal violence, illicit drugs, and HIV/AIDS combined. Why does Hollywood still promote smoking? Is it corrupt? Or stupid?
Boffetta, Paolo; Hecht, Stephen; Gray, Nigel; Gupta, Prakash; Straif, Kurt
Use of smokeless tobacco products is common worldwide, with increasing consumption in many countries. Although epidemiological data from the USA and Asia show a raised risk of oral cancer (overall relative risk 2.6 [95% CI 1.3-5.2]), these are not confirmed in northern European studies (1.0 [0.7-1.3]). Risks of oesophageal cancer (1.6 [1.1-2.3]) and pancreatic cancer (1.6 [1.1-2.2]) have also increased, as shown in northern European studies. Results on lung cancer have been inconsistent, with northern European studies suggesting no excess risk. In India and Sudan, more than 50% of oral cancers are attributable to smokeless tobacco products used in those countries, as are about 4% of oral cancers in US men and 20% of oesophageal and pancreatic cancers in Swedish men. Smokeless tobacco products are a major source of carcinogenic nitrosamines; biomarkers of exposure have been developed to quantify exposure as a framework for a carcinogenesis model in people. Animal carcinogenicity studies strongly support clinical results. Cancer risk of smokeless tobacco users is probably lower than that of smokers, but higher than that of non-tobacco users.
Gaete, Jorge; Araya, Ricardo
We studied the association between individual and contextual variables and the use of tobacco, alcohol, or cannabis in the last 30 days preceding the study, considering the hierarchical nature of students nested in schools. We used the 7th Chilean National School Survey of Substance Use (2007) covering 45,273 students (aged 12-21 years old) along with information from 1465 schools provided by the Chilean Ministry of Education. Multilevel univariable and multivariable logistic regression models were performed. We found a significant intra-class correlation within schools for all substances in the study. Common (e.g., availability of pocket money, more time spent with friends, poor parental monitoring, poor school bonding, bullying others, and lower risk perception of substance use) and unique predictors (e.g., school achievement on national tests) were identified. These findings may help in planning and conducting preventive interventions to reduce substance use.
Nieri, Tanya; Yabiku, Scott; Stromwall, Layne K.; Marsiglia, Flavio Francisco
Efforts to address youth substance use have focused on prevention among non-users and treatment among severe users with less attention given to youth occupying the middle ground who have used substances but not yet progressed to serious abuse or addiction. Using a sample from 35 middle schools of 1,364 youth who reported using substances, this study examined the effectiveness of a universal youth substance use prevention program, the SAMHSA Model Program keepin’ it REAL, in promoting reduced or recently discontinued alcohol, cigarette, and marijuana use. Discrete-time event history methods modeled the rates of reduced and recently discontinued use across four waves of data. Each substance (alcohol, cigarettes, and marijuana) was modeled separately. Beginning at the second wave, participants who reported use at wave 1 were considered at risk of reducing or discontinuing use. Since the data sampled students in schools, multi-level models accounted for the nesting of data at the school level. Results indicated that prevention program participation influenced the rates of reduced and recently discontinued use only for alcohol, controlling for baseline use severity, age, grades, socioeconomic status, ethnicity and gender. Among youth who reported use of alcohol in wave 1 (N= 1,028), the rate of reducing use for program participants was 72% higher than the rate for control students. The rate of discontinuing use was 66% higher than the rate for control students. Among youth who reported use of one or more of the three substances in wave 1 (N = 1,364), the rate of discontinuing all use was 61% higher for program participants than for control students. Limitations and implications of these findings and plans for further research are discussed. PMID:17096196
de la Serna, Elena; Mayoral, María; Baeza, Inmaculada; Arango, Celso; Andrés, Patricia; Bombin, Igor; González, Cristina; Rapado, Marta; Robles, Olalla; Rodríguez-Sánchez, Jose Manuel; Zabala, Arantzazu; Castro-Fornieles, Josefina
To investigate the relationship between cognition and prior cannabis use in children and adolescents presenting a first episode of psychosis. A total of 107 patients with first episode of psychosis and 96 healthy controls, aged 9 to 17 years, were interviewed about their previous substance use and to assess their cognitive functions. Patients were assessed while not using cannabis by means of a comprehensive neuropsychological battery. They were divided into 2 groups depending on the history of prior cannabis use: cannabis users (CU) and cannabis nonusers (CNU). Significant differences were found in all areas evaluated between the 3 groups. Both CU and CNU patients obtained lower scores than controls on verbal learning and memory and working memory. Patients with prior cannabis use performed better on some tests of attention (Continuous performance test (CPT) number of correct responses, p = 0.002; CPT average reaction time, p < 0.001) and executive functions (Trail Making Test, part B (TMT-B) number of mistakes, p < 0.001; Wisconsin Card Sorting Test (WCST) number of categories completed, p < 0.001) than CNU patients. CU patients performed better than CNU subjects on some cognitive measures. This may indicate lower individual vulnerability for psychosis in CU patients in whom cannabis use can be a precipitating factor of psychotic episodes.
Withdrawal from nicotine; Smoking - nicotine addiction and withdrawal; Smokeless tobacco - nicotine addiction; Cigar smoking; Pipe smoking; Smokeless snuff; Tobacco use; Chewing tobacco; Nicotine addiction and tobacco
Smoking tobacco using a waterpipe (hookah) is increasing worldwide and is remarkably common among adolescents and young adults in the United States. Contrary to misperceptions that waterpipe tobacco smoking presents fewer health risks than cigarette smoking, recent data demonstrate clearly that the smoke from a waterpipe contains many of the same toxicants that are in cigarettes, including the dependence-producing drug nicotine, cancer-causing polycyclic aromatic hydrocarbons, pulmonary disease–causing volatile aldehydes, and cardiovascular disease–causing carbon monoxide that can also lead to acute intoxication in waterpipe users. Because many anesthesia providers are likely treating waterpipe tobacco smokers, the goal of this AANA Journal Course is to describe a waterpipe, who uses a waterpipe to smoke tobacco, and the toxicants found in waterpipe smoke and waterpipe smokers. Based on available evidence, there is no indication that waterpipe tobacco smoking is any less risky to patient health than cigarette smoking. Anesthesia providers should begin to assess patients for this form of tobacco use explicitly and should consider addressing it as they do cigarette smoking, with the additional precaution of presurgery carboxyhemoglobin measurement. PMID:24133855
Obaid, H A; Hassan, M A; Mahdy, N H; ElDisouky, M I; Alzarba, F E; Alnayeemi, S R; Rillera, M C; AlMazrooei, B S
Tobacco smoking is an emerging problem among adolescents in the United Arab Emirates (UAE). This study aimed to measure the prevalence of current tobacco use and its associated factors among school students in Dubai Emirate and to determine the impact of an intervention programme on knowledge and attitudes towards tobacco use. A school-based intervention programme was carried out among 2457 students aged 10-20 years and data were collected with a self-administered questionnaire. Of the students, 14.6% were tobacco users, mostly cigarettes (11.2%) and waterpipes (2.2%). The most common self-reported reasons for smoking were for the experience (29.4%), for stress relief (22.5%) and because their peers smoked (21.9%). Stepwise logistic regression analysis showed that the predictors of tobacco use were: male, higher age, UAE national, higher school level, government school, low knowledge about tobacco and family history of smoking. There were significant improvements in knowledge and attitudes scores after the health education intervention programme.
Trent, Linda K; Hilton, Susan M; Melcer, Ted
Recognizing both the medical and operational costs of tobacco use, the Department of Defense has made tobacco cessation a top health promotion priority. Military tobacco rates remain high, however, especially among younger personnel and, particularly, in the Marine Corps. Tobacco is prohibited during basic training, but relapse is common following boot camp graduation. The objective of this study was to determine patterns and prevalence of tobacco use among Marine Corps recruits before entering basic training. Over a period of 14 months, 15,689 graduating male recruits completed a survey of their preservice tobacco use. Approximately 81% reported having tried tobacco at least once and 57% were classified as at-risk users. Compared to their civilian peers, more recruits were daily users and many more used smokeless tobacco. Approximately 67% of users evidenced at least one indicator of dependence. There is a clear need for additional tobacco cessation efforts to target this high-risk population.
Williams, Terrinieka T.; Jason, Leonard A.; Pokorny, Steven B.
This study examined adolescent attitudes towards tobacco control laws. An exploratory factor analysis, using surveys from over 9,000 students, identified the following three factors: (1) youth attitudes towards the efficacy of tobacco control laws, (2) youth attitudes towards tobacco possession laws and (3) youth attitudes towards tobacco sales…
Blake, Linda C.; Roy, Anuradha; Neul, David; Schoenen, Frank J.; Aubé, Jeffrey; Scott, Emily E.
Purpose 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), one of the most prevalent and procarcinogenic compounds in tobacco, is bioactivated by respiratory cytochrome P450 (CYP) 2A13, forming DNA adducts and initiating lung cancer. CYP2A13 inhibition offers a novel strategy for chemoprevention of tobacco-associated lung cancer. Methods Twenty-four analogs of a 4-benzylmorpholine scaffold identified by high throughput screening were evaluated for binding and inhibition of both functional human CYP2A enzymes, CYP2A13 and the 94%-identical hepatic CYP2A6, whose inhibition is undesirable. Thus, selectivity is the major challenge in compound design. Results A key feature resulting in CYP2A13-selective binding and inhibition was substitution at the benzyl ortho position, with three analogs being >25-fold selective for CYP2A13 over CYP2A6. Conclusions Two such analogs were negative for genetic and hERG toxicities and metabolically stable in human lung microsomes, but displayed rapid metabolism in human liver and in mouse and rat lung and liver microsomes, likely due to CYP2B-mediated degradation. A specialized knockout mouse mimicking the human lung demonstrates compound persistence in lung and provides an appropriate test model. Compound delivered by inhalation may be effective in the lung but rapidly cleared otherwise, limiting systemic exposure. PMID:23756756
Maryland State Department of Education, 2008
Periodically, Maryland's sixth, eighth, tenth, and twelfth graders are surveyed to determine the nature, extent, and trend of alcohol, tobacco, and other drug (ATOD) use among adolescents. The "2007 Maryland Adolescent Survey (MAS)" presents the latest findings regarding ATOD use by Maryland's adolescents and compares State and local…
Gould, Nadja Burns; King, Stanley H.
Tobacco smoking among adolescents is reported to be unchanged or increasing in spite of antismoking programs; however, this study reports that college freshmen are responding to information about the dangers of tobacco smoking. (MM)
Nuño-Gutiérrez, Bertha Lidia; Alvarez-Nemegyei, José; Rodriguez-Cerda, Oscar
The aim of this study was to explore the social representations used by the parents of adolescent drug users to explain the onset of drug use. Differences in explanations between the parents of male and female adolescents were also explored. Sixty parents who accompanied their children to four rehabilitation centers in 2004 completed two semi-structured questionnaires. In addition, indepth interviews were applied to a subsample. The explanation of the drug use was carried out through two social representations: the neglectful family and the son or daughter as an inexperienced teen. The parents-son model was well structured; however, the parents-daughter was unstructured, which suggests a higher resonance in the familial group.
Liang, Yunji; Zheng, Xiaolong; Zeng, Daniel Dajun; Zhou, Xingshe; Leischow, Scott James; Chung, Wingyan
Social media is becoming a new battlefield for tobacco "wars". Evaluating the current situation is very crucial for the advocacy of tobacco control in the age of social media. To reveal the impact of tobacco-related user-generated content, this paper characterizes user interaction and social influence utilizing social network analysis and information theoretic approaches. Our empirical studies demonstrate that the exploding pro-tobacco content has long-lasting effects with more active users and broader influence, and reveal the shortage of social media resources in global tobacco control. It is found that the user interaction in the pro-tobacco group is more active, and user-generated content for tobacco promotion is more successful in obtaining user attention. Furthermore, we construct three tobacco-related social networks and investigate the topological patterns of these tobacco-related social networks. We find that the size of the pro-tobacco network overwhelms the others, which suggests a huge number of users are exposed to the pro-tobacco content. These results indicate that the gap between tobacco promotion and tobacco control is widening and tobacco control may be losing ground to tobacco promotion in social media.
Liang, Yunji; Zheng, Xiaolong; Zeng, Daniel Dajun; Zhou, Xingshe; Leischow, Scott James; Chung, Wingyan
Social media is becoming a new battlefield for tobacco “wars”. Evaluating the current situation is very crucial for the advocacy of tobacco control in the age of social media. To reveal the impact of tobacco-related user-generated content, this paper characterizes user interaction and social influence utilizing social network analysis and information theoretic approaches. Our empirical studies demonstrate that the exploding pro-tobacco content has long-lasting effects with more active users and broader influence, and reveal the shortage of social media resources in global tobacco control. It is found that the user interaction in the pro-tobacco group is more active, and user-generated content for tobacco promotion is more successful in obtaining user attention. Furthermore, we construct three tobacco-related social networks and investigate the topological patterns of these tobacco-related social networks. We find that the size of the pro-tobacco network overwhelms the others, which suggests a huge number of users are exposed to the pro-tobacco content. These results indicate that the gap between tobacco promotion and tobacco control is widening and tobacco control may be losing ground to tobacco promotion in social media. PMID:26091553
Renner, Caroline C.
Introduction: We examined the characteristics, attitudes, beliefs, and exposure to tobacco products in a cohort of rural dwelling Alaska Native (AN) people. Methods: We conducted a study of 400 of AN adult tobacco users and nonusers living in Southwestern Alaska. Questionnaires covered variables such as demographics, tobacco-use history, current tobacco use and dependence scales, general health status, attitudes and beliefs about tobacco, and quitting history. Results: The study population smoked 7.8 cigarettes per day compared with 16.8 on average for the U.S. population: a significant proportion of the population engaged in dual use of cigarettes and smokeless tobacco products. Over one third (40.9%), first tried tobacco at age 11 or younger. The mean measures of tobacco addiction (e.g., Fagerstrom Test for Nicotine Dependence, Severson Scale of Smokeless Tobacco Dependence) scores were lower compared with other U.S. populations. Conclusions: Very high tobacco-use prevalence, dual product use, and early tobacco use are observed in Southwestern AN people. Unexpectedly these did not appear to be correlated with heavier individual tobacco use or higher levels of addiction in this population. PMID:22949573
Hurt, Richard D.; Ebbert, Jon O.; Hays, J. Taylor; McFadden, David D.
The US Public Health Service Guideline for Treating Tobacco Use and Dependence 2008 Update emphasizes tobacco use as a chronic medical disorder; highlights both behavioral counseling and the use of 1 or more of the 7 approved medications; and points out the utility, efficacy, and reach of telephone quitlines. The treatment of users of smokeless tobacco continues to be less than optimal. Although providing evidence-based treatment for tobacco-dependent patients is a challenge for busy physicians, a team approach including trained and certified tobacco treatment specialists (TTS) provides an efficient treatment model. TTS represent a new and growing part of the health care team and hold great potential for expanding the collective tobacco treatment expertise in the medical setting. The effective treatment of tobacco dependence frequently requires tailoring, and often intensifying, interventions (both counseling and pharmacotherapy) to meet the needs of the individual patient. PMID:19706827
Hurt, Richard D; Ebbert, Jon O; Hays, J Taylor; McFadden, David D
The US Public Health Service Guideline for Treating Tobacco Use and Dependence 2008 Update emphasizes tobacco use as a chronic medical disorder; highlights both behavioral counseling and the use of 1 or more of the 7 approved medications; and points out the utility, efficacy, and reach of telephone quitlines. The treatment of users of smokeless tobacco continues to be less than optimal. Although providing evidence-based treatment for tobacco- dependent patients is a challenge for busy physicians, a team approach including trained and certified tobacco treatment specialists (TTS) provides an efficient treatment model. TTS represent a new and growing part of the health care team and hold great potential for expanding the collective tobacco treatment expertise in the medical setting. The effective treatment of tobacco dependence frequently requires tailoring, and often intensifying, interventions (both counseling and pharmacotherapy) to meet the needs of the individual patient.
Clawson, Ashley H.; Nicholson, Jody S.; McDermott, Michael J.; Klosky, James L.; Tyc, Vida L.
Introduction Adolescents with cancer are susceptible to the health consequences associated with secondhand smoke exposure (SHSe) and tobacco use. The present study compared tobacco use, exposure, and risk factors between patients and population peers. Method Self-reported data on tobacco use, SHSe, and tobacco-related risk factors were drawn from a pediatric oncology hospital and the National Youth Tobacco Survey. Conditional logistic regression was used to estimate odds ratios for patients and controls. Results Patients were as likely to have tried tobacco and report home SHSe than controls. Patients were more likely to report car SHSe, less likely to report SHSe is harmful, and less likely to report home smoking bans. Discussion Patients experienced SHSe, tobacco use, and tobacco-related risk factors at rates greater than or equal to controls. These results provide support for consideration of intervention targets, health status, and delivery mechanisms, particularly healthcare providers, when developing comprehensive tobacco control strategies. PMID:25204779
... States, chewing tobacco has long been associated with baseball. Players chewed it to keep their mouths moist, ... in most of America and not too many baseball players were spitting big brown gobs all over ...
Conway, Terry L.; Cronan, Terry A.
This study examined the relationships among physical fitness, exercise activity, and both cigarette smoking and smokeless tobacco use among 2,800 United States Navy men. Subgrouping individuals according to their self-reported use of tobacco resulted in maximum sample sizes of 1,406 nonusers, 161 smokeless tobacco users, and 1,233 cigarette…
Braun, S; Mejia, R; Ling, P M; Pérez-Stable, E J
Background/aim Argentina has one of the highest cigarette smoking rates among both men and women in the Americas and no legislated restrictions on tobacco industry advertising. The tobacco industry has traditionally expanded markets by targeting adolescents and young adults. The objective of this study was to determine whether and how the tobacco industry promotes cigarettes to adolescents in Argentina. Methods We conducted a systematic search of tobacco industry documents available through the internet dated between 1995 and 2004 using standard search terms to identify marketing strategies in Argentina. A selected review of the four leading newspapers and nine magazines with reported high readership among adolescents was completed. The selected print media were searched for tobacco images and these were classified as advertisements if associated with a commercial product or as a story if not. Results The tobacco industry used market segmentation as a strategy to target Argentinean consumers. British American Tobacco (BAT) undertook a young adult psychographic study and classified them as “progressives”, “Jurassics” or “conservatives” and “crudos” or “spoiled brats”. BAT marketed Lucky Strike to the “progressives” using Hollywood movies as a vehicle. The tobacco industry also targeted their national brands to the conservatives and linked these brands with “nationalistic values” in advertising campaigns. Philip Morris promoted Marlboro by sponsoring activities directed at young people and they launched the 10 cigarettes packet as a starter vehicle. Conclusions The tobacco industry used psychographic segmentation of the population and developed advertising strategies focused on youth. Tobacco control researchers and advocates must be able to address these strategies in counter-marketing interventions. PMID:18299308
Kaur, Jagdish; Kishore, Jugal; Kumar, Monika
Context: Tobacco use is one of the leading preventable causes of death globally. Mass media plays a significant role in initiation as well as in control of tobacco use. Aims: To assess the effect of viewing anti-tobacco audiovisual messages on knowledge and attitudinal change towards tobacco use. Settings and Design: Interventional community-based study. Materials and Methods: A total of 1999 cinema attendees (age 10 years and above), irrespective of their smoking or tobacco using status, were selected from four cinema halls (two urban, one semi-urban, and one rural site). In pre-exposure phase 1000 subjects and in post-exposure phase 999 subjects were interviewed using a pre-tested questionnaire. After collecting baseline information, the other days were chosen for screening the audiovisual spots that were shown twice per show. After the show, subjects were interviewed to assess its effect. Statistical Analysis Used: Proportions of two independent groups were compared and statistically significance using chi-square test was accepted if error was less than 0.05%. Results: Overall 784 (39.2%) subjects were tobacco users, 52.6% were non-tobacco users and 8.2% were former tobacco users. Important factors for initiation of tobacco use were peer pressure (62%), imitating elders (53.4%) and imitating celebrity (63.5%). Tobacco users were significantly less likely than non-tobacco users to recall watching the spots during movie (72.1% vs. 79.1%). Anti-tobacco advertisement gave inspiration to 37% of subjects not to use tobacco. The celebrity in advertisement influenced the people's attention. There was significant improvement in knowledge and attitudes towards anti-tobacco legal and public health measures in post exposure group. Conclusions: The anti-tobacco advertisements have been found to be effective in enhancing knowledge as well as in transforming to positive attitude of the people about tobacco use. PMID:23293436
Roe, Keith; Salomonsson, Karin
This report is one in a series dealing with Swedish adolescents' uses of video based upon the Media Panel research program, a three-wave, longitudinal research program on video use conducted at the Department of Sociology, the University of Lund, and the Department for Information Techniques, the University College of Vaxjo, Sweden. Data were…
Walker, Denise D; Stephens, Robert; Roffman, Roger; Demarce, Josephine; Lozano, Brian; Towe, Sheri; Berg, Belinda
Cannabis use adversely affects adolescents and interventions that are attractive to adolescents are needed. This trial compared the effects of a brief motivational intervention for cannabis use with a brief educational feedback control and a no-assessment control. Participants were randomized into one of three treatment conditions: Motivational Enhancement Therapy (MET), Educational Feedback Control (EFC), or Delayed Feedback Control (DFC). Those who were assigned to MET and EFC were administered a computerized baseline assessment immediately following randomization and completed assessments at the 3- and 12-month follow-up periods. Participants in the DFC condition were not assessed until the 3-month follow-up. Following the completion of treatment sessions, all participants were offered up to four optional individual treatment sessions aimed at cessation of cannabis use. The research was conducted in high schools in Seattle, Washington. The participant s included 310 self-referred adolescents who smoked cannabis regularly. The main outcome measures included days of cannabis use, associated negative consequences, and engagement in additional treatment. At the 3-month follow-up, participants in both the MET and EFC conditions reported significantly fewer days of cannabis use and negative consequences compared to those in the DFC. The frequency of cannabis use was less in MET relative to EFC at 3 months, but it did not translate to differences in negative consequences. Reductions in use and problems were sustained at 12 months, but there were no differences between MET and EFC interventions. Engagement in additional treatment was minimal and did not differ by condition. Brief interventions can attract adolescent cannabis users and have positive impacts on them, but the mechanisms of the effects are yet to be identified.
Nemeth, Julianna M; Liu, Sherry T; Klein, Elizabeth G; Ferketich, Amy K; Kwan, Mei-Po; Wewers, Mary Ellen
The burden of smokeless tobacco (ST) use disproportionally impacts males in rural Ohio Appalachia. The purpose of this study was to describe the cultural factors contributing to this disparity and to articulate the way in which culture, through interpersonal factors (i.e. social norms and social networks) and community factors (i.e. marketing and availability), impacts ST initiation and use of ST among boys and men in Ohio Appalachia. Fifteen focus groups and 23 individual qualitative interviews were conducted with adult (n = 63) and adolescent (n = 53) residents in Ohio Appalachian counties to ascertain factors associated with ST use and the impact of ST marketing. Transcriptions were independently coded according to questions and themes. ST use appears to be a rite of passage in the development of masculine identity in Ohio Appalachian culture. Interpersonal factors had the greatest influence on initiation and continued use of ST. Ohio Appalachian boys either emulated current ST users or were actively encouraged to use ST through male family and peer networks. Users perceived their acceptance into the male social network as predicated on ST use. Community factors, including ST advertisement and access to ST, reinforced and normalized underlying cultural values. In addition to policy aimed at reducing tobacco marketing and access, interventions designed to reduce ST use in Ohio Appalachia should incorporate efforts to (1) shift the perception of cultural norms regarding ST use and (2) address male social networks as vehicles in ST initiation.
Hatsukami, Dorothy K; Stepanov, Irina; Severson, Herb; Jensen, Joni A; Lindgren, Bruce R; Horn, Kimberly; Khariwala, Samir S; Martin, Julia; Carmella, Steven G; Murphy, Sharon E; Hecht, Stephen S
Smokeless tobacco products sold in the United States vary significantly in yields of nicotine and tobacco-specific nitrosamines (TSNA). With the passage of the Family Smoking Prevention and Tobacco Control Act, the Food and Drug Administration now has the authority to establish product standards. However, limited data exist determining the relative roles of pattern of smokeless tobacco use versus constituent levels in the smokeless tobacco product in exposure of users to carcinogens. In this study, smokeless tobacco users of brands varying in nicotine and TSNA content were recruited from three different regions in the U.S. Participants underwent two assessment sessions. During these sessions, demographic and smokeless tobacco use history information along with urine samples to assess biomarkers of exposure and effect were collected. During the time between data collection, smokeless tobacco users recorded the amount and duration of smokeless tobacco use on a daily basis using their diary cards. Results showed that independent of pattern of smokeless tobacco use and nicotine yields, levels of TSNA in smokeless tobacco products played a significant role in carcinogen exposure levels. Product standards for reducing levels of TSNA in smokeless tobacco products are necessary to decrease exposure to these toxicants and potentially to reduce risk for cancer.
Fakhfakh, Radhouane; Hsairi, Mohamed; Maalej, Mohsen; Achour, Nourredinne; Nacef, Taoufik
OBJECTIVE: To assess tobacco use and the awareness of and attitudes towards tobacco and its control in the adult population of Tunisia. METHODS: A cross-sectional study was conducted in 1996 of a representative national sample of 5696 subjects aged 25 and over. Data were collected by means of a questionnaire in Arabic. FINDINGS: Tobacco use was reported by 30.4% of the respondents, of whom 24.6% smoked cigarettes and 5.8% consumed traditional tobacco, i.e. snuff, chewing tobacco and/or water pipe tobacco. Whereas 55.6% of men used tobacco, only 5.2% of women did so. Among men the proportion of tobacco users diminished with age as the rate of cessation increased. Among women, smoking peaked in the 35-54 age group. The proportion of men consuming traditional tobacco alone increased from 2.4% in the 25-34 age group to 20.4% in the 55+ age group; the corresponding values for women were 0.1% and 14.3%. Tobacco use was more widespread in rural than in urban areas and was relatively high among poorly educated men from economically deprived backgrounds. The use of tobacco was believed to be harmful to health by 98.6% of the respondents. Over 90% of the interviewees were aware that tobacco played a part in the development of heart disease. However, there were some gaps in awareness. A fear of cancer was expressed by 85% of the respondents, whereas only 5.6% were fearful of accidents. CONCLUSIONS: Informational and educational campaigns relating to tobacco control should be directed at individuals and communities, taking into account the gaps in awareness of the effects of tobacco on health. PMID:12077609
de Abranches, Cecy Dunshee; de Assis, Simone Gonçalves; Pires, Thiago de Oliveira
The scope of this research was to investigate the association of psychological violence (PV) during adolescence with social and demographic factors, family structure/relationships and with other forms of maltreatment. A questionnaire was applied to 229 adolescents (11-18 years) in outpatient services in a state-run tertiary pediatric hospital. It was found that 26.4% of respondents suffered severe PV in the family context, and only 5 of the respondents reported they did not suffer any PV in the family context, illustrating how this kind of violence is seen as commonplace in the family relationship. The most common forms of PV behavior were: being criticized for what one does or says; not being encouraged when trying to act autonomously; being called nasty names, and having an adult saying one is wrong when one tries to act. Dissatisfaction of parents with the adolescent, the nuclear family structure, the position of the child among siblings sharing the same parents were associated with PV occurring within the family context. In order to enable it to detect signs of PV, the health sector can promote the right to comprehensive health of adolescents, confirming itself as one of the main social sectors capable of acting preventively on the forms of violence suffered and practiced by the family group.
Sampl, Susan; Kadden, Ronald
This manual is designed to help train substance abuse treatment counselors to conduct a brief five-session treatment intervention for adolescents with cannabis use disorders presenting for outpatient treatment. It combines two sessions of motivational enhancement therapy provided individually and three sessions of cognitive behavioral therapy…
Myers, Mark G.; Prochaska, Judith J.
Although tobacco use is reported by the majority of substance use disordered (SUD) youth, little work has examined tobacco focused interventions with this population. The present study is an initial investigation of the effect of a tobacco use intervention on adolescent SUD treatment outcomes. Participants were adolescents in SUD treatment taking…
Ebbert, Jon O; Severson, Herbert H; Croghan, Ivana T; Danaher, Brian G; Schroeder, Darrell R
Long-term smokeless tobacco (ST) use is associated with cardiovascular disease and cancer, but not all ST users want to quit. Previous studies have evaluated the effectiveness of nicotine lozenges and tobacco-free snuff for reducing ST use among ST users not ready to quit, but no comparative effectiveness trials of these two products have been conducted. We conducted a multicenter, randomized clinical pilot study evaluating the comparative effectiveness of the 4-mg nicotine lozenge and tobacco-free snuff for reducing ST use and increasing tobacco abstinence among ST users with no intention of quitting in the next 30 days. Participants received 8 weeks of treatment and behavioral counseling on tobacco reduction strategies with follow-up to 26 weeks. We randomized 81 participants (40 nicotine lozenges, 41 tobacco-free snuff). No significant differences in reduction were observed between the two groups at weeks 8, 12, and 26. No significant differences were observed between groups in nicotine withdrawal or tobacco craving. However, both groups significantly reduced (p<.001) ST use in cans/week and dips/day from baseline which was sustained through the end-of-study. The observed biochemically-confirmed abstinence rates at week 26 were similar between groups (12% vs. 12%, one-tailed p=.615). The 4-mg nicotine lozenge and the tobacco-free snuff both appear to be effective and comparable for reducing ST use among ST users not ready to quit in the next 30 days.
... Implementation of the Family Smoking Prevention and Tobacco Control Act AGENCY: Food and Drug Administration, HHS... protect children and adolescents as required by the Family Smoking Prevention and Tobacco Control...
... which is a cancerous tumor in the back part of the throat. In 2014, Hall of Famer ... first). Use substitutes such as tobacco-free, mint-leaf snuff; sugarless gum; hard candy; beef jerky; sunflower seeds; shredded coconut; raisins; or dried fruit. Distract yourself ...
Rasmussen-Cruz, Bettylu; Hidalgo-San Martin, Alfredo; Nuno-Gutierrez, Bertha Lidia; Hidalgo-Rasmussen, Carlos
Increased tobacco consumption, specially among adolescents and females, has been observed recently in Mexico. The goal of this study is to describe tobacco consumption and motives for use among university students. A descriptive cross-sectional study was performed using data provided by 282 students aged 15-24 studying at the University of…
Berman, Barbara A.; Guthmann, Debra S.
As part of the effort to reduce cigarette smoking--the single most preventable cause of death in the society--researchers have tried for over half a century to identify effective school-based anti-tobacco education that can discourage tobacco use among children and adolescents. Unfortunately, deaf and hard of hearing young people have been largely…
Battle, Judy Shepps
Adolescent use of alcohol, tobacco, and other drugs is currently increasing. Three out of four adolescents report regular drinking. Significant alcohol, inhalant, and cigarette use is reported as early as fourth grade, and alcohol experimentation increases from 6 to 17 percent between fourth and sixth grades. Adolescence is a high risk stage for…
Chriqui, Jamie; DeLong, Hillary; Gourdet, Camille; Chaloupka, Frank; Edwards, Sarah Matthes; Xu, Xin; Promoff, Gabbi
Tobacco use is the leading cause of preventable disease and death in the United States. Increasing the unit price on tobacco products is the most effective tobacco prevention and control measure. Illicit tobacco trade (illicit trade) undermines high tobacco prices by providing tobacco users with cheaper-priced alternatives. In the United States, illicit trade primarily occurs when cigarettes are bought from states, jurisdictions, and federal reservation land with lower or no excise taxes, and sold in jurisdictions with higher taxes. Applying tax stamps to tobacco products, which provides documentation that taxes have been paid, is an important tool to combat illicit trade. Comprehensive tax stamping policy, which includes using digital, encrypted ("high-tech") stamps, applying stamps to all tobacco products, and working with tribes on stamping agreements, can further prevent and reduce illicit trade. This report describes state laws governing tax stamps on cigarettes, little cigars (cigarette-sized cigars), roll-your-own tobacco (RYOT), and tribal tobacco sales across the United States as of January 1, 2014, and assesses the extent of comprehensive tobacco tax stamping in the United States. Forty-four states (including the District of Columbia [DC]) applied traditional paper ("low-tech") tax stamps to cigarettes, whereas four authorized more effective high-tech stamps. Six states explicitly required stamps on other tobacco products (i.e., tobacco products other than cigarettes), and in approximately one third of states with tribal lands, tribes required tax stamping to address illicit purchases by nonmembers. No U.S. state had a comprehensive approach to tobacco tax stamping. Enhancing tobacco tax stamping across the country might further prevent and reduce illicit trade in the United States.
Lee, Heng; Hsu, Chih-Cheng; Chen, Fu-Li; Yen, Yea-Yin; Lin, Pi-Li; Chiu, Yu-Wen; Lee, Chien-Hung; Peng, Wu-Der; Chen, Ted; Lu, Di-Lin; Huang, Hsiao-Ling
Background: Adolescents who perceive easy access to tobacco are more likely to acquire cigarettes and experience smoking. This study assesses area disparities in perceptions of access to tobacco and cigarette purchasing experiences among schoolchildren. Methods: Data on children's tobacco-related variables were obtained from the Control of…
Mathur, Charu; Stigler, Melissa H.; Erickson, Darin J.; Perry, Cheryl L.; Finnegan, Jonn R., Jr.; Arora, Monika; Reddy, K. Srinath
This study investigates socioeconomic differences in patterns and trends of tobacco consumption over time among youth in India. Additionally, the distribution of tobacco use risk factors across social class was examined. The data were derived from a longitudinal study of adolescents, Project Mobilizing Youth for Tobacco Related Initiatives.…
Leventhal, Adam M; Strong, David R; Sussman, Steve; Kirkpatrick, Matthew G; Unger, Jennifer B; Barrington-Trimis, Jessica L; Audrain-McGovern, Janet
The popularity of electronic (e-) cigarettes has greatly increased recently, particularly in adolescents. However, the extent of psychiatric comorbidity with adolescent e-cigarette use and dual use of conventional (combustible) and e-cigarettes is unknown. This study characterized psychiatric comorbidity in adolescent conventional and e-cigarette use. Ninth grade students attending high schools in Los Angeles, CA (M age = 14) completed self-report measures of conventional/e-cigarette use, emotional disorders, substance use/problems, and transdiagnostic psychiatric phenotypes consistent with the NIMH-Research Domain Criteria Initiative. Outcomes were compared by lifetime use of: (1) neither conventional nor e-cigarettes (non-use; N = 2557, 77.3%); (2) e-cigarettes only (N = 412, 12.4%); (3) conventional cigarettes only (N = 152, 4.6%); and (4) conventional and e-cigarettes (dual use; N = 189, 5.6%). In comparison to adolescents who used conventional cigarettes only, e-cigarette only users reported lower levels of internalizing syndromes (depression, generalized anxiety, panic, social phobia, and obsessive-compulsive disorder) and transdiagnostic phenotypes (i.e., distress intolerance, anxiety sensitivity, rash action during negative affect). Depression, panic disorder, and anhedonia were higher in e-cigarette only vs. non-users. For several externalizing outcomes (mania, rash action during positive affect, alcohol drug use/abuse) and anhedonia, an ordered pattern was observed, whereby comorbidity was lowest in non-users, moderate in single product users (conventional or e-cigarette), and highest in dual users. These findings: (1) raise question of whether emotionally-healthier ('lower-risk') adolescents who are not interested in conventional cigarettes are being attracted to e-cigarettes; (2) indicate that research, intervention, and policy dedicated to adolescent tobacco-psychiatric comorbidity should distinguish conventional cigarette, e-cigarette, and dual use.
Jang, Sung Joon; Johnson, Byron R.
Previous research finds drug-using peers and religiosity to be key predictors of drug use among youth, but the effects of childhood exposure to drug users and religion on later drug use have been understudied. The authors hypothesize a child's exposure to parental drug use and religious upbringing have a causal influence on drug use in youth…
Professor Stanton Glantz
The principal aim of this roadmap is to place the US and Fermilab in the best position to host the International Linear Collider (ILC). The strategy must be resilient against the many vicissitudes that will attend the development of such a large project. Pier Oddone will explore the tension between the needed concentration of effort to move a project as large as the ILC forward and the need to maintain the breadth of our field. America's leading health organizations agree. Smoking on screen is the #1 recruiter of new adolescent smokers in the United States - 390,000 kids a year, of whom 120,000 will die from tobacco-caused diseases. That's more Americans than die from drunk driving, criminal violence, illicit drugs, and HIV/AIDS combined. Why does Hollywood still promote smoking? Is it corrupt? Or stupid?
Chung, Tammy; Pajtek, Stefan; Clark, Duncan B
Readiness to change constitutes an important treatment target. This study examined white matter (WM) integrity as a possible link in the pathway between motivation to abstain and treatment outcome. Adolescents (age 14-18 years, n = 32) were recruited from intensive outpatient (IOP) substance use treatment and reported on motivation to abstain from alcohol and marijuana shortly after treatment admission (i.e., at baseline). Diffusion tensor imaging data were collected approximately 7 weeks after starting IOP and were used to quantify WM integrity (indexed by fractional anisotropy, FA) using a region of interest (ROI) approach. Treatment outcomes were assessed 6 months after baseline. Indirect effects analyses tested FA in prefrontal, orbitofrontal, and temporal ROIs as a linking variable in the pathway from motivation to abstain to alcohol and marijuana outcomes. Bivariate correlations indicated that greater motivation to abstain from alcohol was associated with lower FA in prefrontal, orbitofrontal, and temporal ROIs and that lower FA in these three ROIs was associated with greater 6-month alcohol problem severity. The indirect effect of FA was significant for the prefrontal ROI in the pathway from motivation to outcome for alcohol. FA values were not associated with motivation to abstain from marijuana or marijuana-related outcomes. Results suggest that lower WM integrity, particularly in the prefrontal brain region, may help to explain greater alcohol problem severity at 6 months despite higher motivation to abstain from alcohol. Interventions that aim to enhance WM integrity warrant attention to improve adolescent treatment outcomes.
... Español Category Cancer A-Z What Causes Cancer? Tobacco and Cancer Get information on cigarette, cigar, and ... affects different groups of people. Read more How Tobacco and Smoking Affects Your Health Carcinogens in Tobacco ...
Hovell, M F; Jones, J A; Adams, M A
SMILES PLUS was the first study to extend the clinician-delivered logic model to prevention of tobacco use among adolescents. This multi-site trial with 154 participating offices, based on social learning theory and a behavioral ecological model, was designed to test whether orthodontists can prevent preteens from initiating smoking. The study found that orthodontists do not automatically adhere to anti-tobacco prevention services. Social learning variables can enhance both adherence to counseling guidelines and content of counseling to increase prevention effects. Providing financial incentives, tracking prescriptions, prompting positive feedback from patients, and adopting anti-tobacco counseling models in the office are likely to enhance anti-tobacco preventive services. Training orthodontists to be comfortable when advising nonsmoking youth not to start and to use social consequences to justify youth avoidance of tobacco might increase adherence to protocols and make their counseling more powerful. Adolescent smokers prior to intervention were more likely to start other risky behaviors later. Preventing tobacco use may halt additional risk behaviors and thereby reduce morbidity/mortality even more than expected from tobacco control alone. New and refined clinical trials should be conducted to determine the most effective interventions for adolescent tobacco control by clinicians.
Talhout, Reinskje; Opperhuizen, Antoon; van Amsterdam, Jan G C
Sugars are natural tobacco components, and are also frequently added to tobacco during the manufacturing process. This review describes the fate of sugars during tobacco smoking, in particular the effect of tobacco sugars on mainstream smoke composition. In natural tobacco, sugars can be present in levels up to 20 wt%. In addition, various sugars are added in tobacco manufacturing in amounts up to 4 wt% per sugar. The added sugars are usually reported to serve as flavour/casing and humectant. However, sugars also promote tobacco smoking, because they generate acids that neutralize the harsh taste and throat impact of tobacco smoke. Moreover, the sweet taste and the agreeable smell of caramelized sugar flavors are appreciated in particular by starting adolescent smokers. Finally, sugars generate acetaldehyde, which has addictive properties and acts synergistically with nicotine in rodents. Apart from these consumption-enhancing pyrolysis products, many toxic (including carcinogenic) smoke compounds are generated from sugars. In particular, sugars increase the level of formaldehyde, acetaldehyde, acetone, acrolein, and 2-furfural in tobacco smoke. It is concluded that sugars in tobacco significantly contribute to the adverse health effects of tobacco smoking.
Marijuana that is legally available for adults has multiple implications for adolescent substance use. One potential effect that legalization may have is an increase in adolescent use to due increased availability, greater social acceptance, and possibly lower prices. Legalization may also facilitate the introduction of new formulations of marijuana (edible, vaporized) and with potentially higher potencies. It is unknown what adolescent consumption patterns will be if marijuana is widely available and marketed in different forms, or what effects different patterns of adolescent use will have on cognition, the development of marijuana use disorders, school performance, and the development of psychotic illnesses. Also unclear is whether adolescent users will be experiencing higher levels of tetrahydrocannabinol (THC) compared with previous generations of users due to higher potencies. Although previous studies of the effects of adolescent marijuana use provide some guidance for current policy and public health recommendations, many new studies will be needed that answer questions in the context of use within a legal adult environment. Claims that marijuana has medicinal benefits create additional challenges for adolescent prevention efforts, as they contrast with messages of its harmfulness. Prevention and treatment approaches will need to address perceptions of the safety of marijuana, claims of its medicinal use, and consider family-wide effects as older siblings and parents may increasingly openly consume and advocate for marijuana use. Guidance for primary care physicians will be needed regarded screening and counseling. Widespread legalization and acceptance of marijuana implies that as law enforcement approaches for marijuana control decline, public health, medical, and scientific efforts to understand and reduce negative consequences of adolescent marijuana use need to be substantially increased to levels commensurate with those efforts for tobacco and alcohol.
Marijuana that is legally available for adults has multiple implications for adolescent substance use. One potential effect that legalization may have is an increase in adolescent use to due increased availability, greater social acceptance, and possibly lower prices. Legalization may also facilitate the introduction of new formulations of marijuana (edible, vaporized) and with potentially higher potencies. It is unknown what adolescent consumption patterns will be if marijuana is widely available and marketed in different forms, or what effects different patterns of adolescent use will have on cognition, the development of marijuana use disorders, school performance, and the development of psychotic illnesses. Also unclear is whether adolescent users will be experiencing higher levels of THC compared with previous generations of users due to higher potencies. While previous studies of the effects of adolescent marijuana use provide some guidance for current policy and public health recommendations, many new studies will be needed that answer questions in the context of use within a legal adult environment. Claims that marijuana has medicinal benefits create additional challenges for adolescent prevention efforts as they contrast with messages of its harmfulness. Prevention and treatment approaches will need to address perceptions of the safety of marijuana, claims of its medicinal use, and consider family-wide effects as older siblings and parents may increasingly openly consume and advocate for marijuana use. Guidance for primary care physicians will be needed regarded screening and counseling. Widespread legalization and acceptance of marijuana implies that as law enforcement approaches for marijuana control decline, public health, medical, and scientific efforts to understand and reduce negative consequences of adolescent marijuana use need to be substantially increased to levels commensurate with those efforts for tobacco and alcohol. PMID:25127003
Corey, Catherine G; Ambrose, Bridget K; Apelberg, Benjamin J; King, Brian A
The 2009 Family Smoking Prevention and Tobacco Control Act prohibits "characterizing flavors" (e.g., candy, fruit, and chocolate) other than tobacco and menthol in cigarettes; however, characterizing flavors are not currently prohibited in other tobacco products. Analyses of retail sales data suggest that U.S. consumption of flavored noncigarette tobacco products, including flavored cigars and flavored e-cigarettes, has increased in recent years. There is growing concern that widely marketed varieties of new and existing flavored tobacco products might appeal to youths (2) and could be contributing to recent increases in the use of tobacco products, including e-cigarettes and hookah, among youths. CDC and the Food and Drug Administration (FDA) analyzed data from the 2014 National Youth Tobacco Survey (NYTS) to determine the prevalence of past 30 day use (current use) of flavored e-cigarette, hookah tobacco, cigar, pipe tobacco or smokeless tobacco products, and menthol cigarettes among middle and high school students, and the proportion of current tobacco product users who have used flavored products. An estimated 70.0% (3.26 million) of all current youth tobacco users had used at least one flavored tobacco product in the past 30 days. Among current users, 63.3%, (1.58 million) had used a flavored e-cigarette, 60.6%, (1.02 million) had used flavored hookah tobacco, and 63.5% (910,000) had used a flavored cigar in the past 30 days. Given the millions of current youth tobacco users, it is important for comprehensive tobacco prevention and control strategies to address all forms of tobacco use, including flavored tobacco products, among U.S. youths.
Tessman, Greta K.; Caraballo, Ralph S.; Corey, Catherine G.; Xu, Xin; Chang, Cindy M.
Background Tobacco marketing contributes to increased tobacco use susceptibility and sustained use. There are limited data on youth exposure to tobacco coupons, a type of pro-tobacco promotion. Purpose To explore channels through which youth report exposure to coupons and characteristics associated with this exposure. This may help inform efforts aimed at decreasing youth exposure to advertising and promotion. Methods Data from the 2012 National Youth Tobacco Survey were analyzed in 2013 to estimate the self-reported prevalence of U.S. middle and high school student exposure to coupons through various channels. Associations among exposure to coupons and demographics, tobacco use, living with a tobacco user, and receptivity to tobacco marketing were examined using multivariate logistic regression models. Results Approximately 13% of students reported exposure to tobacco coupons in the past 30 days through mail, digital communications, or tobacco packages. Prevalence was greatest among current tobacco users (34.0%) and those receptive to tobacco marketing (23.4%) compared to non-tobacco users (9.3%) and those not receptive to tobacco marketing (8.2%), respectively. Coupon exposure varied by sex, grade, and race/ethnicity. In adjusted models, current tobacco use (AOR=3.4, 95% CI=3.0, 3.9); living with a tobacco user (AOR=2.1, 95% CI=1.9, 2.4); and receptivity to tobacco marketing (AOR=2.3, 95% CI=2.0, 2.7) were independently associated with coupon exposure. Conclusions Findings from this study indicate that despite restrictions on marketing to youth, youth are still being exposed to tobacco promotions such as coupons. Efforts to limit youth exposure may be valuable in reducing curiosity, susceptibility, and initiation. PMID:25044197
Jones, Alison Snow; Austin, W David; Beach, Robert H; Altman, David G
Assisting tobacco farmers to transition to non-tobacco alternatives is a key element of comprehensive tobacco control's end-game strategy and specifically required by the World Health Organization (WHO) Framework Convention for Tobacco Control (FCTC). We examine the historical relationship between tobacco manufacturers and tobacco farmers in the United States, where the duration of the relationship has been longest and use information obtained to inform possible end-game strategies for tobacco control advocates working with tobacco farmers in developing countries. Tobacco Documents obtained under the Master Settlement Agreement (MSA) provide evidence of conflicts between tobacco manufacturers and tobacco farmers. Findings support WHO FCTC articles aimed at helping developing country tobacco farmers adversely affected by tobacco control efforts and highlight difficulties in discouraging tobacco cultivation as long as it remains relatively profitable. We conclude that successful end-game strategies should take a long-term approach aimed at building alliances with tobacco farmers and at creating mechanisms for tobacco farmer investment in local infrastructure.
Hoek, Janet; Gendall, Philip; Gifford, Heather; Pirikahu, Gill; McCool, Judith; Pene, Gina; Edwards, Richard; Thomson, George
We use brand association and symbolic consumption theory to explore how plain cigarette packaging would influence the identities young adults cocreate with tobacco products. Group discussions and in-depth interviews with 86 young adult smokers and nonsmokers investigated how participants perceive tobacco branding and plain cigarette packaging with larger health warnings. We examined the transcript data using thematic analysis and explored how removing tobacco branding and replacing this with larger warnings would affect the symbolic status of tobacco brands and their social connotations. Smokers used tobacco brand imagery to define their social attributes and standing, and their connection with specific groups. Plain cigarette packaging usurped this process by undermining aspirational connotations and exposing tobacco products as toxic. Replacing tobacco branding with larger health warnings diminishes the cachet brand insignia creates, weakens the social benefits brands confer on users, and represents a potentially powerful policy measure.
Abad-Vivero, Erika N; Thrasher, James F; Arillo-Santillán, Edna; Pérez-Hernández, Rosaura; Barrientos-Gutíerrez, Inti; Kollath-Cattano, Christy; Mejía, Raúl; Sargent, James D
Background Use of flavour capsule varieties (FCVs) of cigarettes has rapidly increased in many countries. Adolescents are attracted to flavours; yet, surprisingly, no quantitative study has explored adolescents' perceptions of these products. Objective To characterise the appeal of FCVs for young adolescents in Mexico. Methods In 2015, surveys were conducted with a representative sample of Mexican middle school students (n=10 124; ages 11–16 years; mean 12.4 years). Students viewed and rated packs for FCVs and non-FCVs from major brands (Marlboro, Camel, Pall Mall), with brand names removed. For each pack, students were asked to write the brand name (ie, brand recall), to evaluate pack attractiveness, and to indicate the pack they were most interested in trying (including a ‘none’ option). Logistic generalised estimating equation (GEE) models regressed brand recall, pack attractiveness and interest in trying on brand and FCV (yes vs no), controlling for sociodemographics and smoking risk factors. Results Marlboro regular, Camel regular, Camel light and Pall Mall FCVs were most often recalled (25%, 17%, 9%, 8%). Packs for Pall Mall FCVs and Camel FCVs were most often rated as very attractive (13%, 9%, respectively) and of interest for trial (22%, 13%) along with Marlboro regular (14%). In GEE models, FCVs were independently associated with greater attractiveness (adjusted OR (AOR)=1.83, 95% CI 1.72 to 1.94) and interest in trying (AOR=1.74, 95% CI 1.54 to 1.96). Perceived pack attractiveness was also independently associated with greater interest in trying (AOR=5.63, 95% CI 4.74 to 6.68). Conclusions FCVs appear to be generating even greater appeal among young adolescents than established non-FCVs in dominant brand families. PMID:27060099
Centers for Disease Control and Prevention (DHHS/PHS), Atlanta, GA.
This report on smoking and health, the twenty-third in a series that was begun in 1964, is the first in this series to focus on young people. It underscores the seriousness of tobacco use and its relationship to other adolescent problem behaviors. Examined here are the past few decades' scientific literature on the factors that influence the onset…
Marsch, Lisa A.; Guarino, Honoria; Grabinski, Michael J.; Syckes, Cassandra; Dillingham, Elaine T.; Xie, Haiyi; Crosier, Benjamin S.
Background Young people who engage in substance use are at risk for becoming infected with HIV and diseases with similar transmission dynamics. Effective disease prevention programs delivered by prevention specialists exist but are rarely provided in systems of care due to staffing/resource constraints and operational barriers - and are thus of limited reach. Web-based prevention interventions could possibly offer an effective alternative to prevention specialist-delivered interventions and may enable widespread, cost-effective access to evidence-based prevention programming. Previous research has shown the HIV/disease prevention program within the web-based Therapeutic Education System (TES) to be an effective adjunct to a prevention specialist-delivered intervention. The present study was the first randomized, clinical trial to evaluate the comparative effectiveness of this web-based intervention as a standalone intervention relative to a traditional, prevention specialist-delivered intervention. Methods Adolescents entering outpatient treatment for substance use participated in this multi-site trial. Participants were randomly assigned to either a traditional intervention delivered by a prevention specialist (n = 72) or the web-delivered TES intervention (n = 69). Intervention effectiveness was assessed by evaluating changes in participants’ knowledge about HIV, hepatitis, and sexually transmitted infections, intentions to engage in safer sex, sex-related risk behavior, self-efficacy to use condoms, and condom use skills. Findings Participants in the TES intervention achieved significant and comparable increases in HIV/disease-related knowledge, condom use self-efficacy, and condom use skills and comparable decreases in HIV risk behavior relative to participants who received the intervention delivered by a prevention specialist. Participants rated TES as easier to understand. Conclusion This study indicates that TES is as effective as HIV/disease prevention
Summerlin-Long, Shelley K.; Goldstein, Adam O.
Background: Since most tobacco users become addicted to nicotine as teenagers, prevention efforts for youth remain central to comprehensive prevention programs. National and state efforts that encourage adoption and enforcement of comprehensive tobacco-free school (TFS) policies can lead to significant reductions of youth tobacco use. In 2003,…
Geiger, Brian F.
This paper describes lessons learned while planning a statewide conference to increase the knowledge of tobacco control advocates and promote implementation of the Alabama Comprehensive Tobacco Use Prevention and Control Plan (Plan) within the state. The Plan has three overall goals: preventing youth from becoming tobacco users; promoting…
Everett, Sherry A.; Husten, Corinne G.; Warren, Charles W.; Crossett, Linda; Sharp, Donald
Examined demographic characteristics of high school tobacco-users across gender and ethnicity using data from the 1991-1995 Youth Risk Behavior Survey. Current smoking increased, with one-third of 9th and 12th graders currently smoking in 1995 and 11% of all students using smokeless tobacco. Many students used tobacco before high school. Tobacco…
Lazovich, DeAnn; Forster, Jean; Widome, Rachel; VanCoevering, Pam
State youth access laws often include restrictions for minor possession, use, or purchase of tobacco (PUP). The Minnesota PUP law allows cited youth to attend a tobacco diversion program in lieu of fines. We surveyed county attorneys in all counties (N = 87), tobacco diversion program coordinators (N = 47), and adolescents (N = 3,377) to assess PUP enforcement level, tobacco diversion program quality, and youth awareness of and experience with PUP laws and penalties. Although almost all county attorneys reported enforcement of the law, mean citation rates were low (9.3/1,000 youth) but somewhat higher in counties with tobacco diversion programs than in counties without such programs. Program coordinators also reported low attendance (Mdn = 30 adolescents per year per program). Almost 70% of classes were 2 h or less, and just 21.3% included multiple sessions; little variation in program approach or materials was observed, nor did programs meet criteria recommended for effective smoking cessation programs in this population. Overall, 59% of adolescents (79% among smokers) reported having heard of adolescents being caught by police or at school for smoking. Smoking prevalence was lower in counties with tobacco diversion programs than in counties without such programs (11.6% vs. 14.6%; adjusted OR = 0.8, 95% CI = 0.6-1.1). Receipt of a citation and attendance in a special class were more commonly reported among past-month smokers who lived in counties with tobacco diversion programs; the association for class attendance reached statistical significance. Our adolescent data provide some support for PUP laws as a potential tobacco control strategy, yet low citation rates and attendance in diversion programs of limited scope reduce the likelihood of detecting any benefit associated with this approach.
Agaku, Israel T; Odani, Satomi; Sturgis, Stephanie; Harless, Charles; Glover-Kudon, Rebecca
on brand sponsorship, smokeless tobacco products continue to be marketed in sports in the United States, potentially through other indirect channels such as corporate-name sponsorship. Enhanced measures are warranted to restrict youth-oriented tobacco marketing and promotional activities that could lead to tobacco initiation and use among children and adolescents (2). Reducing tobacco industry promotion through sponsorship of public and private events is an evidence-based strategy for preventing youth initiation of tobacco use (3). In addition, other proven interventions (e.g., tobacco price increases, anti-tobacco mass media campaigns, tobacco-free policies inclusive of smokeless tobacco, and barrier-free access to cessation services), could help reduce smokeless tobacco use in the United States (1).
Cecil, C A M; Walton, E; Smith, R G; Viding, E; McCrory, E J; Relton, C L; Suderman, M; Pingault, J-B; McArdle, W; Gaunt, T R; Mill, J; Barker, E D
Epigenetic processes have been implicated in addiction; yet, it remains unclear whether these represent a risk factor and/or a consequence of substance use. Here, we believe we conducted the first genome-wide, longitudinal study to investigate whether DNA methylation patterns in early life prospectively associate with substance use in adolescence. The sample comprised of 244 youth (51% female) from the Avon Longitudinal Study of Parents and Children (ALSPAC), with repeated assessments of DNA methylation (Illumina 450k array; cord blood at birth, whole blood at age 7) and substance use (tobacco, alcohol and cannabis use; age 14–18). We found that, at birth, epigenetic variation across a tightly interconnected genetic network (n=65 loci; q<0.05) associated with greater levels of substance use during adolescence, as well as an earlier age of onset amongst users. Associations were specific to the neonatal period and not observed at age 7. Key annotated genes included PACSIN1, NEUROD4 and NTRK2, implicated in neurodevelopmental processes. Several of the identified loci were associated with known methylation quantitative trait loci, and consequently likely to be under significant genetic control. Collectively, these 65 loci were also found to partially mediate the effect of prenatal maternal tobacco smoking on adolescent substance use. Together, findings lend novel insights into epigenetic correlates of substance use, highlight birth as a potentially sensitive window of biological vulnerability and provide preliminary evidence of an indirect epigenetic pathway linking prenatal tobacco exposure and adolescent substance use. PMID:27922636
Agaku, Israel T; Singh, Tushar; Jones, Sherry Everett; King, Brian A; Jamal, Ahmed; Neff, Linda; Caraballo, Ralph S
Athletes are not a typical at-risk group for smoking combustible tobacco products, because they are generally health conscious and desire to remain fit and optimize athletic performance (1). In contrast, smokeless tobacco use historically has been associated with certain sports, such as baseball (2). Athletes might be more likely to use certain tobacco products, such as smokeless tobacco, if they perceive them to be harmless (3); however, smokeless tobacco use is not safe and is associated with increased risk for pancreatic, esophageal, and oral cancers (4). Tobacco use among youth athletes is of particular concern, because most adult tobacco users first try tobacco before age 18 years (5). To examine prevalence and trends in current (≥1 day during the past 30 days) use of combustible tobacco (cigarettes, cigars) and smokeless tobacco (chewing tobacco, snuff, or dip [moist snuff]) products among athlete and nonathlete high school students, CDC analyzed data from the 2001–2013 National Youth Risk Behavior Surveys. Current use of any tobacco (combustible or smokeless tobacco) significantly declined from 33.9% in 2001 to 22.4% in 2013; however, current smokeless tobacco use significantly increased from 10.0% to 11.1% among athletes, and did not change (5.9%) among nonathletes. Furthermore, in 2013, compared with nonathletes, athletes had significantly higher odds of being current smokeless tobacco users (adjusted odds ratio [AOR] = 1.77, p<0.05), but significantly lower odds of being current combustible tobacco users (AOR = 0.80, p<0.05). These findings suggest that opportunities exist for development of stronger tobacco control and prevention measures targeting youth athletes regarding the health risks associated with all forms of tobacco use.
Cobb, Caroline; Ward, Kenneth D.; Maziak, Wasim; Shihadeh, Alan L.; Eissenberg, Thomas
Objective To examine the prevalence and potential health risks of waterpipe tobacco smoking. Methods A literature review was performed to compile information relating to waterpipe tobacco smoking. Results Waterpipe tobacco smoking is increasing in prevalence worldwide; in the United States, 10–20% of some young adult populations are current waterpipe users. Depending on the toxicant measured, a single waterpipe session produces the equivalent of at least 1 and as many as 50 cigarettes. Misconceptions about waterpipe smoke content may lead users to underestimate health risks. Conclusion Inclusion of waterpipe tobacco smoking in tobacco control activities may help reduce its spread. PMID:20001185
Asma, Samira; Song, Yang; Cohen, Joanna; Eriksen, Michael; Pechacek, Terry; Cohen, Nicole; Iskander, John
During the 20th century, use of tobacco products contributed to the deaths of 100 million persons worldwide. In 2011, approximately 6 million additional deaths were linked to tobacco use, the world's leading underlying cause of death, responsible for more deaths each year than human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis, and malaria combined. One third to one half of lifetime users die from tobacco products, and smokers die an average of 14 years earlier than nonsmokers. Manufactured cigarettes account for 96% of all tobacco sales worldwide. From 1880 to 2009, annual global consumption of cigarettes increased from an estimated 10 billion cigarettes to approximately 5.9 trillion cigarettes, with five countries accounting for 58% of the total consumption: China (38%), Russia (7%), the United States (5%), Indonesia (4%), and Japan (4%). Among the estimated 1 billion smokers worldwide, men outnumber women by four to one. In 14 countries, at least 50% of men smoke, whereas in more than half of these same countries, fewer than 10% of women smoke. If current trends persist, an estimated 500 million persons alive today will die from use of tobacco products. By 2030, tobacco use will result in the deaths of approximately 8 million persons worldwide each year. Yet, every death from tobacco products is preventable.
Schivo, Michael; Avdalovic, Mark V; Murin, Susan
Cigarette smoking is known to cause a wide range of damaging health outcomes; however, the effects of non-cigarette tobacco products are either unknown or perceived as less harmful than cigarettes. Smokeless tobacco, cigar smoking, and waterpipe smoking have increased in usage over the past few decades. Some experts believe that their use is reaching epidemic proportions. Factors such as a perception of harm reduction, targeted advertising, and unrecognized addiction may drive the increased consumption of non-cigarette tobacco products. In particular, the need for social acceptance, enjoyment of communal smoking activities, and exotic nature of waterpipe smoking fuels, in part, its popularity. The public is looking for "safer" alternatives to smoking cigarettes, and some groups advertise products such as smokeless tobacco and electronic cigarettes as the alternatives they seek. Though it is clear that cigar and waterpipe tobacco smoking are probably as dangerous to health as cigarette smoking, there is an opinion among users that the health risks are less compared to cigarette smoking. This is particularly true in younger age groups. In the cases of smokeless tobacco and electronic cigarettes, the risks to health are less clear and there may be evidence of a harm reduction compared to cigarettes. In this article, we discuss commonly used forms of non-cigarette tobacco products, their impacts on lung health, and relevant controversies surrounding their use.
John, Rijo M
The tax base of tobacco in India is heavily dependent on about 14% of tobacco users, who smoke cigarettes. Non-cigarette tobacco products accounting for 85% of the tobacco consumption contributes only 15% of the total tobacco taxes. Though taxation is an important tool to regulate consumption of tobacco, there have been no estimates of price elasticities for different tobacco products in India to date, which can guide tax policy on tobacco. This paper, for the first time in India, examines the price elasticity of demand for bidis, cigarettes and leaf tobacco at the national level using a representative cross-section of households. This study found that own-price elasticity estimates of different tobacco products in India ranged between -0.4 to -0.9, with bidis (an indigenous hand-rolled smoked tobacco preparation in India) and leaf tobacco having elasticities close to unity. Cigarettes were the least price elastic of all. With some assumptions, it is shown that the tax on bidis can be increased to Rs. 100 per 1000 sticks compared with the current Rs. 14 and the tax on an average cigarette can be increased to Rs. 3.5 per stick without any fear of losing revenue. The paper argues that the current system of taxing cigarettes in India based on the presence of filters and the length of cigarettes has no justification on health grounds, and should be abolished, if reducing tobacco consumption and the consequent disease burden is one of the objectives of tobacco taxation policy. It also argues that attempts to regulate tobacco use without effecting significant tax increases on bidis may not produce desired results.
Robertson, J.B.; Bray, J.T.
Using X-ray fluorescence spectrometry, 11 heavy elements at concentrations that are easily detectable have been identified in smokeless tobacco products. These concentrations were found to increase in cheek epithelium samples of the user after exposure to smokeless tobacco. This feasibility study suggests that the level of strontium in the cheek epithelium could be a valid measure of recent smokeless tobacco use. It also demonstrates that strontium levels become undetectable within several days of smokeless tobacco cessation. This absence of strontium could validate a self-report of abstinence from smokeless tobacco. Finally, the X-ray spectrum of heavy metal content of cheek epithelium from smokeless tobacco users could itself provide a visual stimulus to further motivate the user to terminate the use of smokeless tobacco products.
... users, cigar smokers, and smokeless tobacco users. Alternate Text: The figure above is a bar chart showing ... MMWR paper copy for printable versions of official text, figures, and tables. An original paper copy of ...
Berlin, Ivan; Hakes, Jahn K.; Hu, Mei-Chen; Covey, Lirio S.
Background Suicide has been associated with smoking/tobacco use but its association of and change in smoking/tobacco use status with suicide attempt (SA) is not well established. Methods We investigated whether persistent, former tobacco use, initiation, quitting tobacco use, relapse to tobacco use, and DSM-IV nicotine dependence predict independently SA using Wave 1 and 2 data of the National Epidemiologic Survey of Alcohol and Related Conditions. Data from 34,653 US adults interviewed at Wave 1 (2001-02) and Wave 2 (2004-05) were analyzed. The main outcome measure was SA between Wave 1 and Wave 2 as reported at Wave 2. Results Among the 1,673 respondents reporting lifetime SA at Wave 2, 328 individuals reported SA between Wave 1 and Wave 2. Current and former tobacco use at Wave 1 predicted Wave 2 SA independently of socio-demographic characteristics, psychiatric history, and prior SA (Adjusted Odds Ratio (AOR): 1.49; 95% CI: 1.13-1.95, AOR: 1.31; 95% CI:1.01-1.69, respectively versus never tobacco users). The strongest association with SA was observed among former tobacco users who relapsed after Wave 1 (AOR: 4.66; 95% CI: 3.49-6.24) and among tobacco use initiators after Wave 1 (AOR: 3.16; 95% CI: 2.23-4.49). Persistent tobacco use (current tobacco use at both Wave 1 and Wave 2) also had an increased risk of SA (AOR: 1.89; 95% CI: 1.47-2.42). However, former tobacco users in both Waves 1 and 2 did not show a significantly elevated risk for SA in Wave 2 (AOR:1.09, 95% CI: 0.78-1.52) suggesting that the risk resided mainly in Wave 1 former tobacco users who relapsed to tobacco use by Wave 2. DSM-IV nicotine dependence did not predict SA at Wave 2. Conclusion In a representative sample of US adults, relapse, tobacco use initiation, and persistent tobacco use, which are amenable to intervention, were associated with risk of SA. PMID:25849514
... Drug Administration authority to regulate tobacco products and marketing. The Campaign for Tobacco-Free Kids was a ... gives the FDA authority to regulate the manufacturing, marketing and sale of tobacco products National Tobacco Control ...
... and Pregnancy Text Size: A A A Smokeless Tobacco and Your Health Can smokeless tobacco affect my ... tobacco use cause other health problems? Can smokeless tobacco affect my oral health? It may cause tooth ...
Fass, Daniel; Calhoun, Georgia B.; Glaser, Brian A.; Yanosky, Daniel J., II
The authors investigated the differences in characteristics and risk behaviors endorsed by detained adolescent methamphetamine users and compared them with other drug users. Subjects completed the Millon Adolescent Clinical Inventory and a questionnaire in which sociodemographics and behavioral information were explored and compared. Multivariate…
Drope, Jeffrey M.; Graetz, Ilana; Waters, Teresa M.; Kaplan, Cameron M.
In 2014, few health insurance plans sold in the Affordable Care Act’s Federally Facilitated Marketplaces had age-dependent tobacco surcharges, possibly because of a system glitch. The 2015 tobacco surcharges show wide variation, with more plans implementing tobacco surcharges that increase with age. This underscores concerns that older tobacco users will find postsubsidy health insurance premiums difficult to afford. Future monitoring of enrollment will determine whether tobacco surcharges cause adverse selection by dissuading tobacco users, particularly older users, from buying health insurance. PMID:26447913
... 2,10 Community programs that reduce tobacco advertising, promotions, and availability of tobacco products 2,10 Some ... National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2016 ...
Pérez De La Barrera, Citlalli
A cross-sectional study was carried out with the purpose of validating seven life skills scales reported in the literature as related to drug-abuse prevention, and which identify differences between these skills among non-user adolescent students and users of alcohol, tobacco, cannabis and inhalants. The sample was made up of 425 adolescents, 196 (46.1%) male and 229 (53.9%) female. These participants were randomly selected from a private high school in the state of Morelos, and their mean age was 15.8 years, with a standard deviation of 1.97. To measure skills we used the scales validated in this survey, while patterns of drug use were measured with a scale based on the National Addiction Survey (2008) indicators. Results showed that students who did not use alcohol, tobacco, cannabis or inhalants scored higher in skills of empathy, future orientation and peer pressure resistance, compared to those who had used these substances in the last month. On the basis of these findings it would seem necessary to develop drug-abuse prevention programs for high school students based on a life skills training approach.
McDaniel, Patricia A; Smith, Elizabeth A; Malone, Ruth E
The tobacco endgame concept reorients discussion away from the persistent control of tobacco toward plans for ending the tobacco epidemic, and envisions a tobacco-free future. A variety of policy approaches have been proposed, with many offered prior to the introduction of the unifying term ‘endgame’. We conducted a qualitative synthesis of the literature on tobacco control endgames, and drew on media accounts and discussion of analogous ideas for illustrative purposes. We identified proposals focused on the product, user, market/supply or larger institutional structures. Research on public support for these proposals was limited, but suggestive of some public appetite for endgame ideas. Advocates should be encouraged to explore new policy options and consider the goal of a tobacco-free future. PMID:26320149
Bogdanovica, Ilze; McNeill, Ann; Britton, John
Objective A prospective evaluation of the effect of 2012 point-of-sale (PoS) display ban in supermarkets in England on perceived exposure to PoS displays, and on changes in susceptibility and smoking uptake among young people. Design Cohort study. Settings Seven schools in Nottinghamshire, England. Participants 1035 11–16-year-old school children. Primary and secondary outcome measures Changes in reported exposure to PoS displays before and after prohibition, and the association between exposure to and awareness of PoS displays and change in susceptibility to smoking and smoking status between 2011 and 2012 (before the ban) and 2012 and 2013 (after the ban). Results The proportion of children noticing tobacco PoS displays in supermarkets most or every time they visited a shop changed little between 2011 and 2012 (59.6% (95% CI 56.6% to 62.6%) and 58.8% (95% CI 55.8% to 61.8%), respectively); but decreased by about 13 percentage points to 45.7% (95% CI 42.7% to 48.7%) in 2013, after the ban. However, after adjusting for confounders, implementation of the first stage of the PoS ban in 2012 did not result in significant changes in the relation between susceptibility to smoking and smoking status and exposure to and awareness of PoS displays. Conclusions Prohibition of PoS in large supermarkets resulted in a decline in the proportion of young people noticing PoS displays in large shops, but little or no change in smoking uptake or susceptibility. It remains to be seen whether extension of the PoS ban to all shops in 2015 has a more marked effect. PMID:28115330
This paper will review the epidemiology of the impact of cigarette smoking and other forms of tobacco exposure on human development. Sources of exposure described include cigarettes and other forms of smoked tobacco, secondhand (environmental) tobacco smoke, several forms of smok...
Bromberg, Maggie H.; Noel, Melanie; Groenewald, Cornelius; Murphy, Lexa K.; Palermo, Tonya M.
Objective To compare rates of alcohol and tobacco use in youth with and without chronic pain and to identify risk factors for use. Methods Participants included 186 youth (95 mixed chronic pain; 91 without chronic pain; 12–18 years old) who reported current alcohol and tobacco use, pain intensity, activity limitations, loneliness, and depressive symptoms. Results Adolescents with chronic pain were less likely to use alcohol compared with adolescents without chronic pain (7.4% vs. 22%), and as likely to use tobacco (9% vs. 8%). Across groups, youth with higher depressive symptoms, less loneliness, and fewer activity limitations were more likely to endorse alcohol and tobacco use. Exploratory analyses revealed that risk factors for substance use differed among youth with and without chronic pain. Conclusions Chronic pain may not increase risk for tobacco and alcohol use in adolescents. Research is needed to understand use of other substances in this medically vulnerable population. PMID:25617047
Husten, Corinne G; Deyton, Lawrence R
The USA has a rich history of public health efforts to reduce morbidity and mortality from tobacco use. Comprehensive tobacco-prevention programmes, when robustly implemented, reduce the prevalence of youth and adult smoking, decrease cigarette consumption, accelerate declines in tobacco-related deaths, and diminish health-care costs from tobacco-related diseases. Effective public health interventions include raising the price of tobacco products, smoke-free policies, counter-marketing campaigns, advertising restrictions, augmenting access to treatment for tobacco use through insurance coverage and telephone help lines, and comprehensive approaches to prevent children and adolescents from accessing tobacco products. The US Food and Drug Administration (FDA) has six major areas of regulatory authority: regulation of tobacco products; regulation of the advertising, marketing, and promotion of tobacco products; regulation of the distribution and sales of tobacco products; enforcement of the provisions of the Tobacco Control Act and tobacco regulations; regulatory science to support FDA authorities and activities; and public education about the harms of tobacco products and to support FDA regulatory actions. With passing of the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) in June, 2009, important new regulatory approaches were added to the tobacco prevention and control arsenal.
Crankshaw, Erik C.; Beach, Robert H.; Austin, W. David; Altman, David G.; Jones, Alison Snow
Purpose: To examine tobacco farmers' attitudes toward tobacco control, public health, and tobacco manufacturers in order to determine the extent to which rapidly changing economic conditions have influenced North Carolina tobacco farmer attitudes in ways that may provide tobacco control advocates with new opportunities to promote tobacco control…
Woods, Susan Swartz; Jaén, Carlos Roberto
Health professionals play an important role in addressing patient tobacco use in clinical settings. While there is clear evidence that identifying tobacco use and assisting smokers in quitting affects outcomes, challenges to improve routine, clinician-delivered tobacco intervention persist. The Consumer Demand Initiative has identified simple design principles to increase consumers' use of proven tobacco treatments. Applying these design strategies to activities across the healthcare system, we articulate ten recommendations that can be implemented in the context of most clinical systems where most clinicians work. The recommendations are: (1) reframe the definition of success, (2) portray proven treatments as the best care, (3) redesign the 5A's of tobacco intervention, (4) be ready to deliver the right treatment at the right time, (5) move tobacco from the social history to the problem list, (6) use words as therapy and language that makes sense, (7) fit tobacco treatment into clinical team workflows, (8) embed tobacco treatment into health information technology, (9) make every encounter an opportunity to intervene, and (10) end social disparities for tobacco users. Clinical systems need to change to improve tobacco treatment implementation. The consumer- and clinician-centered recommendations provide a roadmap that focuses on increasing clinician performance through greater understanding of the clinician's role in helping tobacco users, highlighting the value of evidence-based tobacco treatments, employing shared decision-making skills, and integrating routine tobacco treatment into clinical system routines.
Djordjevic, Mirjana V; Doran, Kelly A
Nicotine is the principal alkaloid in both commercial and homemade products (e.g., cigarettes, smokeless tobacco, bidis, waterpipes) followed by nornicotine, anabasine, anatabine, and many other basic substances that contain a cyclic nitrogenous nucleus. Tobacco types, leaf position on the plant, agricultural practices, fertilizer treatment, and degree of ripening are among some prominent factors that determine the levels of alkaloids in tobacco leaf. From a random examination of 152 cultivated varieties of Nicotiana tabacum, a range of alkaloid variation between 0.17 and 4.93% was determined. In fact, every step in tobacco production that affects plant metabolism will influence the level of alkaloid content to a certain degree. Depending on blending recipe, type and amount of additives, and product design, all types of tobacco products contain a very wide range of nicotine concentration. However, the ultimate emission of nicotine to the user, exposure, and psychophar-macological effects depend not only on the content and emission, but also on the relationship between the product and the user.
Crawford, M; Balch, G; Mermelstein, R
Objective: Explore adolescents' response to current and potential tobacco control policy issues. Design: The 13 site Tobacco Control Network (TCN), sponsored by the Centers for Disease Control and Prevention, conducted 129 sex and ethnic homogeneous focus groups. Participants: 785 white, African American, Asian American/Pacific Islander, American Indian, and Hispanic adolescents who were primarily smokers from rural, urban, and suburban locations across the USA. Main outcome measures: Awareness, knowledge, opinions, and behaviour regarding laws and rules, prices, cigarette ingredients, and warning labels. Results: Teenagers were generally familiar with laws and rules about access and possession for minors, but believed them ineffective. They were knowledgeable about prices, and reported that a sharp and sudden increase could lead them to adjust their smoking patterns but could also have negative consequences. They found a list of chemical names of cigarette ingredients largely meaningless, but believed that disclosing and publicising their common uses could be an effective deterrent, especially for those who were not yet smoking. They were aware of current warning labels, but considered them uninformative and irrelevant. Conclusions: Understanding teenagers' attitudes and behaviours before implementing policies that will affect them will likely increase their effectiveness. Disclosing and publicising the chemical contents of cigarettes, and increasing prices quickly and sharply, are potentially effective areas for policy change to impact adolescent tobacco use. PMID:11891362
Sims, Tammy H
Tobacco use is the leading preventable cause of morbidity and death in the United States. Because 80% to 90% of adult smokers began during adolescence, and two thirds became regular, daily smokers before they reached 19 years of age, tobacco use may be viewed as a pediatric disease. Every year in the United States, approximately 1.4 million children younger than 18 years start smoking, and many of them will die prematurely from a smoking-related disease. Moreover, there is recent evidence that adolescents report symptoms of tobacco dependence early in the smoking process, even before becoming daily smokers. The prevalence of tobacco use is higher among teenagers and young adults than among older adult populations. The critical role of pediatricians in helping to reduce tobacco use and addiction and secondhand tobacco-smoke exposure in the pediatric population includes education and prevention, screening and detection, and treatment and referral.
The majority of the world's 1.3 billion tobacco users are men, but female use is increasing. To examine differences in tobacco use and awareness of tobacco marketing by sex, CDC and health officials in Bangladesh, Thailand, and Uruguay (among the first countries to report results) analyzed 2009 data from a newly instituted survey, the Global Adult Tobacco Survey (GATS). This report summarizes the results of that analysis, which indicated wide variation among the three countries in tobacco use, product types used, and marketing awareness among males and females. In Bangladesh and Thailand, use of smoked tobacco products was far greater among males (44.7% and 45.6%, respectively) than females (1.5% and 3.1%, respectively). In Uruguay, the difference was smaller (30.7% versus 19.8%). Use of smokeless tobacco products in Bangladesh was approximately the same among males (26.4%) and females (27.9%), but females were significantly more likely to use smokeless tobacco in Thailand (6.3% versus 1.3%), and use in Uruguay by either sex was nearly nonexistent. Males in Bangladesh were twice as likely as females to notice cigarette advertising (68.0% versus 29.3%), but the difference between males and females was smaller in Thailand (17.4% versus 14.5%) and Uruguay (49.0% versus 40.0%). In all three countries, awareness of tobacco marketing was more prevalent among females aged 15--24 years than older women. Comprehensive bans on advertising, sponsorship, and promotion of tobacco products, recommended by the World Health Organization (WHO), can reduce per capita cigarette consumption if enforced.
Kyaing, Nyo Nyo; Islam, Md Ashadul; Sinha, Dhirendra N; Rinchen, Sonam
This paper examines the social, cultural, economic and legal dimensions of tobacco control in the South-East Asia Region in a holistic view through the review of findings from various studies on prevalence, tobacco economics, poverty alleviation, women and tobacco and tobacco control laws and regulations. Methods were Literature review of peer reviewed publications, country reports, WHO publications, and reports of national and international meetings on tobacco and findings from national level surveys and studies. Tobacco use has been a social and cultural part of the people of South-East Asia Region. Survey findings show that 30% to 60% of men and 1.8% to 15.6% of women in the Region use one or the other forms of tobacco products. The complex nature of tobacco use with both smoking and smokeless forms is a major challenge for implementing tobacco control measures. Prevalence of tobacco use is high among the poor and the illiterate. It is higher among males than females but studies show a rising trend among girls and women due to intensive marketing of tobacco products by the tobacco industry. Tobacco users spend a huge percent of their income on tobacco which deprives them and their families of proper nutrition, good education and health care. Some studies of the Region show that cost of treatment of diseases attributable to tobacco use was more than double the revenue that governments received from tobacco taxation. Another challenge the Region faces is the application of uniform tax to all forms of tobacco, which will reduce not only the availability of tobacco products in the market but also control people switching over to cheaper tobacco products. Ten out of eleven countries are Parties to the WHO Framework Convention on Tobacco Control and nine countries have tobacco control legislation. Enforcement of control measures is weak, particularly in areas such as smoke-free environments, advertisement at the point of sale and sale of tobacco to minors. Socio
Viswanath, Kasisomayajula; Herbst, Roy S; Land, Stephanie R; Leischow, Scott J; Shields, Peter G
new tobacco products; the impact of altering the levels of addictive components in tobacco products; the identification of risk and risk-reduction measures for current and former tobacco users; enhanced early detection methods for tobacco-related cancers; and effective treatments against tobacco-related cancers tailored to the unique effects of tobacco on cancer. Pursue domestic and international economic policies that support tobacco control. Urge the United States to ratify the World Health Organization Framework Convention on Tobacco Control. Foster global scientific efforts to support the Framework. Work together with stakeholders worldwide, including federal agencies, to develop and implement effective tobacco control strategies and to deter counter-tobacco control efforts by the tobacco industry. Only such concerted global actions by scientists, policymakers, and advocates together can prevent the invidious impact of tobacco, the use of which is cutting wide swathes of death and disease around the world.
Sundh, Mona; Hagquist, Curt
The purpose of this study was to increase understanding of the prerequisites for tobacco prevention. The situations before and after the introduction of a minimum-age law were compared with respect to opportunities for adolescents to buy tobacco, and to attitudes towards the law. Data were collected in 1996 and 2000 with a questionnaire among all…
Cheney, Marshall K.; Oman, Roy F.; Vesely, Sara K.; Aspy, Cheryl B.; Tolma, Eleni L.
Background: Youth assets protect adolescents from tobacco use, but their influence in young adulthood is unknown. Purpose: To determine the prospective influence of assets possessed in young adulthood with tobacco use the following year. Methods: Data from waves 4 and 5 from the Youth Asset Study (n = 450, ages 18-22 at wave 5) were used. Logistic…
Poms, Laura W.; Fleming, Lila C.; Jacobsen, Kathryn H.
Background: Parenting practices have been shown to have a strong influence on adolescent tobacco use in high-income countries. This study examined whether parenting practices also were associated with tobacco use by middle school students (approximately ages 13-15) in low- and middle-income countries. Methods: A secondary analysis was performed on…
DiFranza, J.; Coleman, M.
AIM—To determine how youths obtain tobacco in communities with strong enforcement of tobacco sales laws. SETTING—Ten communities in Massachusetts with merchant compliance rates at or above 90%. METHODS—Paper surveys and focus group discussions with 68 adolescent smokers. RESULTS—Parents and friends are the primary sources of tobacco for new smokers. When stealing from parents can no longer satisfy the need for cigarettes, young adolescents ask strangers to buy them tobacco. For high school age smokers, teenage store clerks are a major source. Teenage clerks sell to other teenagers, steal tobacco, and help their friends steal from their employers. Friends who are 18 years of age or over are a second major source for older adolescents. Parents often purchase tobacco for older adolescents. CONCLUSION—Recommended actions include raising the minimum age for the purchase of tobacco to 21 years, and prohibiting individuals less than 21 years of age from selling tobacco. Keywords: youth; youth access laws PMID:11740022
Leon, Maria E; Peruga, Armando; McNeill, Ann; Kralikova, Eva; Guha, Neela; Minozzi, Silvia; Espina, Carolina; Schüz, Joachim
Tobacco use, and in particular cigarette smoking, is the single largest preventable cause of cancer in the European Union (EU). All tobacco products contain a wide range of carcinogens. The main cancer-causing agents in tobacco smoke are polycyclic aromatic hydrocarbons, tobacco-specific N-nitrosamines, aromatic amines, aldehydes, and certain volatile organic compounds. Tobacco consumers are also exposed to nicotine, leading to tobacco addiction in many users. Cigarette smoking causes cancer in multiple organs and is the main cause of lung cancer, responsible for approximately 82% of cases. In 2012, about 313,000 new cases of lung cancer and 268,000 lung cancer deaths were reported in the EU; 28% of adults in the EU smoked tobacco, and the overall prevalence of current use of smokeless tobacco products was almost 2%. Smokeless tobacco products, a heterogeneous category, are also carcinogenic but cause a lower burden of cancer deaths than tobacco smoking. One low-nitrosamine product, snus, is associated with much lower cancer risk than other smokeless tobacco products. Smoking generates second-hand smoke (SHS), an established cause of lung cancer, and inhalation of SHS by non-smokers is still common in indoor workplaces as well as indoor public places, and more so in the homes of smokers. Several interventions have proved effective for stopping smoking; the most effective intervention is the use of a combination of pharmacotherapy and behavioural support. Scientific evidence leads to the following two recommendations for individual action on tobacco in the 4th edition of the European Code Against Cancer: (1) "Do not smoke. Do not use any form of tobacco"; (2) "Make your home smoke-free. Support smoke-free policies in your workplace".
Erdöl, Cevdet; Ergüder, Toker; Morton, Jeremy; Palipudi, Krishna; Gupta, Prakash; Asma, Samira
Waterpipe tobacco smoking (WTS) is an emerging tobacco product globally, especially among adolescents and young adults who may perceive WTS as a safe alternative to smoking cigarettes. Monitoring the use of WTS in Turkey in relation to the tobacco control policy context is important to ensure that WTS does not become a major public health issue in Turkey. The Global Adult Tobacco Survey (GATS) was conducted in Turkey in 2008 and was repeated in 2012. GATS provided prevalence estimates on current WTS and change over time. Other indicators of WTS were also obtained, such as age of initiation and location of use. Among persons aged 15 and older in Turkey, the current prevalence of WTS decreased from 2.3% in 2008 to 0.8% in 2012, representing a 65% relative decline. Among males, WTS decreased from 4.0% to 1.1% (72% relative decline). While the overall smoking prevalence decreased among females, there was no change in the rate of WTS (0.7% in 2008 vs. 0.5% in 2012), though the WTS prevalence rate was already low in 2008. Comprehensive tobacco control efforts have been successful in reducing the overall smoking prevalence in Turkey, which includes the reduction of cigarette smoking and WTS. However, it is important to continue monitoring the use of waterpipes in Turkey and targeting tobacco control efforts to certain groups that may be vulnerable to future WTS marketing (e.g., youth, women). PMID:26670238
Erdöl, Cevdet; Ergüder, Toker; Morton, Jeremy; Palipudi, Krishna; Gupta, Prakash; Asma, Samira
Waterpipe tobacco smoking (WTS) is an emerging tobacco product globally, especially among adolescents and young adults who may perceive WTS as a safe alternative to smoking cigarettes. Monitoring the use of WTS in Turkey in relation to the tobacco control policy context is important to ensure that WTS does not become a major public health issue in Turkey. The Global Adult Tobacco Survey (GATS) was conducted in Turkey in 2008 and was repeated in 2012. GATS provided prevalence estimates on current WTS and change over time. Other indicators of WTS were also obtained, such as age of initiation and location of use. Among persons aged 15 and older in Turkey, the current prevalence of WTS decreased from 2.3% in 2008 to 0.8% in 2012, representing a 65% relative decline. Among males, WTS decreased from 4.0% to 1.1% (72% relative decline). While the overall smoking prevalence decreased among females, there was no change in the rate of WTS (0.7% in 2008 vs. 0.5% in 2012), though the WTS prevalence rate was already low in 2008. Comprehensive tobacco control efforts have been successful in reducing the overall smoking prevalence in Turkey, which includes the reduction of cigarette smoking and WTS. However, it is important to continue monitoring the use of waterpipes in Turkey and targeting tobacco control efforts to certain groups that may be vulnerable to future WTS marketing (e.g., youth, women).
Poston, Walker SC; Haddock, Christopher K.; Jahnke, Sara A.; Day, Rena S.
Introduction: To date, there have been no large-scale, national epidemiological studies of tobacco use patterns among firefighters, particularly with a focus on smokeless tobacco (SLT) and dual use with cigarettes. While rates of firefighters’ smoking are relatively low compared to the general population, SLT use typically is substantially higher than the populations they protect. In the current study, we systemically examine tobacco use, including SLT and dual use, and the health-related profiles of various tobacco use groups in a national sample of career firefighters. Methods: Data are from a national cohort study of career departments (N = 20) comprised of 947 male firefighters. Results: Among 947 participants, 197 (21%) were tobacco users, of which, 34.5% used cigarettes, 53.2% used SLT, and 12.2% used both cigarettes and SLT. Adjusted rates of smoking, SLT use, and dual use were 13.2%, 10.5%, and 12.2%, respectively. Tobacco users of all types were significantly younger and had served fewer years in fire service and were significantly more likely to engage in heavy and binge drinking, as well as more likely to show signs of depressive symptoms compared to nontobacco users. Conclusions: Detailed information on tobacco use pattern will aid in better understanding what factors are contributing to the high rates of SLT and dual use among firefighters in order to guide and develop an appropriate treatment program for the fire service. PMID:25145378
Maity, Nivedita; Chand, Prabhat; Murthy, Pratima
One in three adults in India uses tobacco, a highly addictive substance in one or other form. In addition to prevention of tobacco use, offering evidence-based cessation services to dependent tobacco users constitutes an important approach in addressing this serious public health problem. A combination of behavioral methods and pharmacotherapy has shown the most optimal results in tobacco dependence treatment. Among currently available pharmacological agents, drugs that preferentially act on the α4 β2-nicotinic acetyl choline receptor like varenicline and cytisine appear to have relatively better cessation outcomes. These drugs are in general well tolerated and have minimal drug interactions. The odds of quitting tobacco use are at the very least doubled with the use of partial agonists compared with placebo and the outcomes are also superior when compared to nicotine replacement therapy and bupropion. The poor availability of partial agonists and specifically the cost of varenicline, as well as the lack of safety data for cytisine has limited their use world over, particularly in developing countries. Evidence for the benefit of partial agonists is more robust for smoking rather than smokeless forms of tobacco. Although more studies are needed to demonstrate their effectiveness in different populations of tobacco users, present literature supports the use of partial agonists in addition to behavioral methods for optimal outcome in tobacco dependence. PMID:24574554
Avenevoli, Shelli; Merikangas, Kathleen Ries
The family unit is the primary source of transmission of basic social, cultural, genetic, and biological factors that may underlie individual differences in smoking. Existing information on the role of familial factors in tobacco use is characterized by two separate, but somewhat overlapping, lines of research: genetic epidemiological studies and risk-factor research. The present paper summarizes and evaluates studies assessing the association between adolescent smoking and parent and sibling smoking behaviors. A review of 87 studies reveals that methods are limited by a lack of standardized instruments, failure to measure important confounding and mediating factors, reliance on cross-sectional designs and the use of inconsistent definitions of tobacco-related behavior and assessment procedures. Moreover, there are no systematic family studies of the acquisition and continuation of smoking that have employed contemporary methodological standards for examining familial aggregation of tobacco behaviors among adolescents. Findings across studies show weak and inconsistent associations between parent and adolescent smoking; inconsistent findings may be attributed to methodological issues or associated factors that may complicate the relation between parent and adolescent smoking. Sibling and peer smoking show greater associations with adolescent smoking. Suggestions for future research include contemporary family studies that delineate meaningful phenotypes of tobacco use and prospective work on the later stages of tobacco use and the timing of the influence and valence of parent and family factors. Integration of the risk factor approach within the family study design may enrich both approaches to elucidate familial influences on smoking.
Yel, Daravuth; Bui, Anthony; Job, Jayakaran S; Knutsen, Synnove; Singh, Pramil N
There remains a very high rate of smoked and smokeless tobacco use in the Western Pacific Region. The most recent findings from national adult tobacco surveys indicate that very few daily users of tobacco intend to quit tobacco use. In Cambodia, a nation that is predominantly Buddhist, faith-based tobacco control programs have been implemented where, under the fifth precept of Buddhism that proscribes addictive behaviors, monks were encouraged to quit tobacco and temples have been declared smoke-free. In the present study, we included items on a large national tobacco survey to examine the relation between beliefs (faith-based, other) about tobacco, health, and addiction among adults (18 years and older). In a stratified, multistage cluster sample (n=13,988) of all provinces of Cambodia, we found that (1) 88-93% believe that Buddhist monks should not use tobacco, buy tobacco, or be offered tobacco during a religious ceremony; (2) 86-93% believe that the Wat (temple) should be a smoke-free area; (3) 93-95% believe that tobacco is addictive in the same way as habits (opium, gambling, alcohol) listed under the fifth precept of Buddhism; and (4) those who do not use tobacco are significantly more likely to cite a Buddhist principle as part of their anti-tobacco beliefs. These data indicate that anti-tobacco sentiments are highly prevalent in the Buddhist belief system of Cambodian adults and are especially evident among non-users of tobacco. Our findings indicate that faith-based initiatives could be an effective part of anti-tobacco campaigns in Cambodia.
Tu, Andrew W.; Ratner, Pamela A.; Johnson, Joy L.
Adolescents' gender-specific cannabis use rates and their correlates were examined. Data were obtained via a cross-sectional survey conducted in 2004 in British Columbia, Canada, funded by the Canadian Institutes of Health Research. School districts were invited to participate, and schools within consenting districts were recruited. In total, 8,225 students (50% male)from Grades 7 to 12 participated. About 73% were “White” and 47% had used cannabis in their lifetime. Cannabis users were grouped according to their frequency of use: “never users” “frequent users” or “heavy users” Male heavy cannabis users (14.3% of boys) were more likely to be in Grade 9 or higher; be Aboriginal; report poorer economic status; never feel like an outsider; frequently use alcohol and tobacco; and have lower satisfaction with family, friends, and school compared with boys that never used. Female heavy users (8.7% of girls) were more likely to be in a higher grade; report poorer economic status, mental health, and academic performance; frequently use alcohol and tobacco; and have lower satisfaction with their school compared with female never users. Three important gender differences in the multivariate analysis of the correlates of cannabis use were noted: school grade (for boys only), Aboriginal status (for boys only), and mental health (for girls only). Despite the limitations of relying on self-reports, a subset of youth appears to be at risk for excessive cannabis use that may impair life opportunities and health. The gender differences may be important in the design and implementation of prevention or treatment programs for adolescents. PMID:18696378
Kumari, Ranjeeta; Nath, Bhola
Objectives: Is use of tobacco a major health problem among medical students? To find out the factors associated with the use of tobacco. Materials and Methods: A cross-sectional study was done on 250 undergraduate male medical students using a pre-designed, pre-tested questionnaire to study about the problem and various correlates of the tobacco use. Data was collected and analysed using Excel and SPSS software. Results: Among the tobacco users (28.8%), smoking was found in 87.5% and tobacco chewing in the form of gutka, khaini, gulmanjan (locally available forms of tobacco) in 37.5% as the predominant means of the use of tobacco. The mean age of our sample was 23.5 years. The residential background, i.e., rural or urban, and religion were not significantly associated with the use of tobacco in the present study. Hostellers were found to be more frequent tobacco users as compared to day-scholars. There was a familial aggregation of the use of tobacco. The factor initiating the use of tobacco was usually peer pressure. Conclusion: Tobacco use is a significant problem among the male medical students and we need to take steps to stop its use by them so as to prevent them from being exposed to its hazardous effects. This will also make their role in the advocacy of the smoking cessation activities more trustworthy. PMID:19967033
Stevens, Perry; Alexander, Vickie L.; Allison, Harmony; Coole, David F.; Fishman, Julie A.; Knox, Steven R.; Malarcher, Ann M.; Schooley, Michael W.; Shelton, Dana M.; Woollery, Trevor A.
This document provides a compilation of tobacco information for all 50 states and the District of Columbia, covering topics such as the prevalence of tobacco use, the health impact and costs associated with tobacco use, tobacco control laws, and tobacco agriculture and manufacturing. Recommended practices for school-based programs are included.…
Arora, Monika; Tewari, Abha; Grills, Nathan; Nazar, Gaurang P.; Sonrexa, Juhi; Gupta, Vinay K.; Moodie, Rob; Reddy, K. S.
This study assessed perceptions and support among the Indian populace about plain packaging for all tobacco products. Twelve focus group discussions (n = 124), stakeholder analysis with 24 officials and an opinion poll with 346 participants were conducted between December 2011 and May 2012, Delhi. Plain packages for tobacco products were favored by majority of participants (69%) and key stakeholders (92%). The majority of participants perceived that plain packaging would reduce the appeal and promotional value of the tobacco pack (>80%), prevent initiation of tobacco use among children and youth (>60%), motivate tobacco users to quit (>80%), increase notice ability, and effectiveness of pictorial health warnings on tobacco packs (>90%), reduce tobacco usage (75% of key stakeholders). Majority of participants favored light gray color for plain packaging. This study provides key evidence to advocate with Indian Government and other countries in South Asia region to introduce plain packaging legislation for all tobacco products. PMID:24350204
Arora, Monika; Tewari, Abha; Grills, Nathan; Nazar, Gaurang P; Sonrexa, Juhi; Gupta, Vinay K; Moodie, Rob; Reddy, K S
This study assessed perceptions and support among the Indian populace about plain packaging for all tobacco products. Twelve focus group discussions (n = 124), stakeholder analysis with 24 officials and an opinion poll with 346 participants were conducted between December 2011 and May 2012, Delhi. Plain packages for tobacco products were favored by majority of participants (69%) and key stakeholders (92%). The majority of participants perceived that plain packaging would reduce the appeal and promotional value of the tobacco pack (>80%), prevent initiation of tobacco use among children and youth (>60%), motivate tobacco users to quit (>80%), increase notice ability, and effectiveness of pictorial health warnings on tobacco packs (>90%), reduce tobacco usage (75% of key stakeholders). Majority of participants favored light gray color for plain packaging. This study provides key evidence to advocate with Indian Government and other countries in South Asia region to introduce plain packaging legislation for all tobacco products.
Yue, L. )
The present study was conducted to determine the cadmium level in tobacco planted in five main tobacco-producing areas, a cadmium polluted area, and in cigarettes produced domestically (54 brands). The results indicate that average cadmium content in tobacco was 1.48 (0.10-4.95 mg/kg), which was similar to that of Indian tobacco (1.24 mg/kg), but the cadmium of tobacco produced in the cadmium polluted area was quite high (8.60 mg/kg). The average cigarette cadmium was 1.05 micrograms/g (with filter tip) and 1.61 micrograms/g (regular cigarette). Therefore special attention should be paid to the soil used in planting tobacco.
Colle, Romain; Trabado, Séverine; Rotenberg, Samuel; Brailly-Tabard, Sylvie; Benyamina, Amine; Aubin, Henri-Jean; Hardy, Patrick; Falissard, Bruno; Becquemont, Laurent; Verstuyft, Céline; Fève, Bruno; Corruble, Emmanuelle
Since serum Brain Derived Neurotrophic Factor (BDNF) levels are higher in tobacco smokers than in non-smokers and since Major Depressive Disorder (MDD) is associated with a 2-fold increased risk of smoking, we assessed the association of smoking and plasma BDNF levels in 359 depressed MDD patients. Plasma BDNF levels were positively correlated with the magnitude of tobacco consumption (current number of cigarettes/day and number of packs/year). Accordingly, current tobacco users had significantly higher plasma BDNF levels than non-users. In further studies of MDD, peripheral measures of BDNF should take into account tobacco use.
Introduction: This paper was written in response to a request from the U.S. National Cancer Institute. The goal is to discuss some research directions related to establishing tobacco product standards under the Family Smoking Prevention and Tobacco Control Act, which empowers the U.S. Food and Drug Administration to regulate tobacco products. Potential research related to tobacco product ingredients, nicotine, and harmful or potentially harmful constituents of tobacco products is discussed. Discussion: Ingredients, which are additives, require less attention than nicotine and harmful or potentially harmful constituents. With respect to nicotine, the threshold level in tobacco products below which dependent users will be able to freely stop using the product if they choose to do so is a very important question. Harmful and potentially harmful constituents include various toxicants and carcinogens. An updated list of 72 carcinogens in cigarette smoke is presented. A crucial question is the appropriate levels of toxicants and carcinogens in tobacco products. The use of carcinogen and toxicant biomarkers to determine these levels is discussed. Conclusions: The need to establish regulatory standards for added ingredients, nicotine, and other tobacco and tobacco smoke constituents leads to many interesting and potentially highly significant research questions, which urgently need to be addressed. PMID:21324834
Smoking is proven to have an adverse effect on an individual's health. Long term use of tobacco products has a cumulative effect leading to compromised physiology of several body systems. Clinical research studies support the premise that tobacco users are at an increased risk for surgical complications. Individuals with a history of tobacco abuse present a challenge to the nurse. Throughout the perioperative phase the nurse initiates interventions to prevent or minimize complications. This article presents a general overview of the adverse effects of tobacco on the surgical patient and nursing interventions when caring for a patient with a history of tobacco abuse.
Kowitt, Sarah D; Meernik, Clare; Baker, Hannah M; Osman, Amira; Huang, Li-Ling; Goldstein, Adam O
Although a few countries have banned flavored cigarettes (except menthol), flavors in most tobacco products remain unregulated across the globe. We conducted a systematic review of qualitative studies examining perceptions of and experiences with flavored non-menthol tobacco products. Of 20 studies on flavored tobacco products included in our qualitative systematic review, 10 examined hookah, six examined e-cigarettes, two examined little cigars and cigarillos (LCCs), and three examined other tobacco products, including cigarettes. The majority of studies, regardless of product type, reported positive perceptions of flavored tobacco products, particularly among young adults and adolescents. In six studies that assessed perceptions of harm (including hookah, LCCs, and other flavored tobacco products), participants believed flavored tobacco products to be less harmful than cigarettes. In studies that examined the role of flavors in experimentation and/or initiation (including three studies on e-cigarettes, one hookah study and one LCC study), participants mentioned flavors as specifically leading to their experimentation and/or initiation of flavored tobacco products. Given that many countries have not yet banned flavors in tobacco products, these findings add to existing research on why individuals use flavored tobacco products and how they perceive harm in flavored tobacco products, providing further support for banning non-menthol flavors in most tobacco products.
Shimkhada, Riti; Peabody, John W
Legislation to control tobacco use in developing countries has lagged behind the dramatic rise in tobacco consumption. India, the third largest grower of tobacco in the world, amassed 1.7 million disability-adjusted life years (DALYs) in 1990 due to disease and injury attributable to tobacco use in a population where 65% of the men and 38% of the women consume tobacco. India's anti-tobacco legislation, first passed at the national level in 1975, was largely limited to health warnings and proved to be insufficient. In the last decade state legislation has increasingly been used but has lacked uniformity and the multipronged strategies necessary to control demand. A new piece of national legislation, proposed in 2001, represents an advance. It includes the following key demand reduction measures: outlawing smoking in public places; forbidding sale of tobacco to minors; requiring more prominent health warning labels; and banning advertising at sports and cultural events. Despite these measures, the new legislation will not be enough to control the demand for tobacco products in India. The Indian Government must also introduce policies to raise taxes, control smuggling, close advertising loopholes, and create adequate provisions for the enforcement of tobacco control laws.
Shimkhada, Riti; Peabody, John W.
Legislation to control tobacco use in developing countries has lagged behind the dramatic rise in tobacco consumption. India, the third largest grower of tobacco in the world, amassed 1.7 million disability-adjusted life years (DALYs) in 1990 due to disease and injury attributable to tobacco use in a population where 65% of the men and 38% of the women consume tobacco. India's anti-tobacco legislation, first passed at the national level in 1975, was largely limited to health warnings and proved to be insufficient. In the last decade state legislation has increasingly been used but has lacked uniformity and the multipronged strategies necessary to control demand. A new piece of national legislation, proposed in 2001, represents an advance. It includes the following key demand reduction measures: outlawing smoking in public places; forbidding sale of tobacco to minors; requiring more prominent health warning labels; and banning advertising at sports and cultural events. Despite these measures, the new legislation will not be enough to control the demand for tobacco products in India. The Indian Government must also introduce policies to raise taxes, control smuggling, close advertising loopholes, and create adequate provisions for the enforcement of tobacco control laws. PMID:12640476
Fallin, Amanda; Glantz, Stanton A
Context The 5 major tobacco-growing states (Kentucky, North Carolina, South Carolina, Tennessee, and Virginia) are disproportionately affected by the tobacco epidemic, with higher rates of smoking and smoking-induced disease. These states also have fewer smoke-free laws and lower tobacco taxes, 2 evidence-based policies that reduce tobacco use. Historically, the tobacco farmers and hospitality associations allied with the tobacco companies to oppose these policies. Methods This research is based on 5 detailed case studies of these states, which included key informant interviews, previously secret tobacco industry documents (available at http://legacy.library.ucsf.edu), and media articles. This was supplemented with additional tobacco document and media searches specifically for this article. Findings The tobacco companies were particularly concerned about blocking tobacco-control policies in the tobacco-growing states by promoting a pro-tobacco culture, beginning in the late 1960s. Nevertheless, since 2003, there has been rapid progress in the tobacco-growing states’ passage of smoke-free laws. This progress came after the alliance between the tobacco companies and the tobacco farmers fractured and hospitality organizations stopped opposing smoke-free laws. In addition, infrastructure built by National Cancer Institute research projects (COMMIT and ASSIST) led to long-standing tobacco-control coalitions that capitalized on these changes. Although tobacco production has dramatically fallen in these states, pro-tobacco sentiment still hinders tobacco-control policies in the major tobacco-growing states. Conclusions The environment has changed in the tobacco-growing states, following a fracture of the alliance between the tobacco companies and their former allies (tobacco growers and hospitality organizations). To continue this progress, health advocates should educate the public and policymakers on the changing reality in the tobacco-growing states, notably the
Fu, Qiang; Vaughn, Michael G; Wu, Li-Tzy; Heath, Andrew C
Compared to the association between cigarette smoking and psychiatric disorders, relatively little is known about the relationship between smokeless tobacco use and psychiatric disorders. To identify the psychiatric correlates of smokeless tobacco use, the analysis used a national representative sample from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) wave 1. Smokeless tobacco use was classified as exclusive snuff use, exclusive chewing tobacco, and dual use of both snuff and chewing tobacco at some time in the smokeless tobacco user's life. Lifetime psychiatric disorders were obtained via structured diagnostic interviews. The results show that the prevalence of lifetime exclusive snuff use, exclusive chewing tobacco, and dual use of both snuff and chewing tobacco was 2.16%, 2.52%, and 2.79%, respectively. After controlling for sociodemographic variables and cigarette smoking, the odds of exclusive chewing tobacco in persons with panic disorder and specific phobia were 1.53 and 1.41 times the odds in persons without those disorders, respectively. The odds of exclusive snuff use, exclusive chewing tobacco, and dual use of both products for individuals with alcohol use disorder were 1.97, 2.01, and 2.99 times the odds for those without alcohol use disorder, respectively. Respondents with cannabis use disorder were 1.44 times more likely to use snuff exclusively than those without cannabis use disorder. Respondents with inhalant/solvent use disorder were associated with 3.33 times the odds of exclusive chewing tobacco. In conclusion, this study highlights the specific links of anxiety disorder, alcohol, cannabis, and inhalant/solvent use disorders with different types of smokeless tobacco use.
Lee, Dustin C.; Budney, Alan J.; Brunette, Mary F.; Hughes, John R.; Etter, Jean-Francois; Stanger, Catherine
BACKGROUND Cannabis users frequently report concurrent tobacco use, and tobacco use is associated with poorer outcomes during treatment for cannabis use disorders (CUD). Interventions that simultaneously target both tobacco and cannabis use disorders may enhance cessation outcomes for either or both substances. METHODS This study evaluated an intervention integrating highly effective treatments for cannabis and tobacco use disorders. Thirty-two participants meeting diagnostic criteria for CUD and reporting daily tobacco use were enrolled in a 12-week computer-assisted behavioral treatment for CUD. Participants were encouraged to participate in a tobacco intervention that included a computer-assisted behavioral treatment tailored for tobacco and cannabis co-users, and nicotine-replacement therapy (NRT). Cannabis and tobacco outcomes were evaluated using descriptive statistics and were compared to a historical control group that received treatment for CUD but not tobacco. RESULTS Participants achieved 3.6 ± 4.3 consecutive weeks of cannabis abstinence, which was comparable to the historical control group (3.1 ± 4.4). A majority of the sample (78%) completed at least one tobacco module and 44% initiated NRT. Over half (56%) initiated tobacco quit attempts, and 28% were tobacco abstinent for at least two consecutive weeks. Participants showed greater reduction in tobacco use (cigarettes per day) than the historical control group, but differences in tobacco abstinence rates during the final month of treatment were not statistically significant (12.5% vs 4%). CONCLUSION Findings suggest that providing a tobacco intervention during treatment for CUD is feasible and may positively impact tobacco use without negatively affecting cannabis use outcomes. PMID:26307942
Delaware Univ., Newark. Kids Count in Delaware.
This Kids Count special report examines attitudes of adolescents in Delaware toward smoking and the use of tobacco products. Data are based on interviews with middle and high school students conducted by journalism students at Glasgow High School under the supervision of their teacher, and on statewide data. The report presents statewide data and…
Rogers, Deirdre B; Vance, Ralph B
Mississippians are failing in their health status particularly as it relates to tobacco use. According to the Behavioral Risk Factor Surveillance System, 2008, 22.7% of Mississippi adults are current smokers compared to 18.4% of U.S. adults. This gives Mississippi a ranking of seventh among the states and the District of Columbia. Considering that smoking is the leading cause of preventable death, change must occur in our state. Resources necessary to combat the problem of tobacco use in Mississippi are available, but it is important that tobacco users are aware of their availability and how to access those resources. Physicians can positively impact the tobacco use statistics by counseling their tobacco dependent patients on the need for cessation and what counseling and pharmacotherapy resources are available to help the patient break his or her addiction.
Villanti, Andrea; Boulay, Marc; Juon, Hee-Soon
Previous studies of social influences on adolescent smoking have focused on peers and parents, using data collected prior the 1998 Master Settlement Agreement. This study used the 2004 wave of the National Youth Tobacco Survey to examine associations between peer smoking, smoking at home, tobacco-related media exposure, and smoking behavior during early and middle adolescence. Findings indicate that peer smoking and smoking at home remain strongly associated with current smoking among early and middle adolescents, controlling for gender, race/ethnicity and exposure to tobacco industry and anti-tobacco media. The magnitude of the association between peer smoking and current smoking decreases from early adolescence to middle adolescence while the association between smoking at home and current smoking is static across developmental stage. Exposure to tobacco-related media is associated with increased current and former smoking in both early and middle adolescence.
Hrywna, Mary; Delnevo, Cristine D; Lewis, M Jane
This study examined the prevalence and characteristics of New Jersey adults who reported seeing tobacco products advertised on the Internet and described the means by which these products were advertised. Data were analyzed from the New Jersey Adult Tobacco Survey (NJATS), a repeated, cross-sectional, random-digit-dial telephone survey conducted with a statewide representative sample. We used logistic regression to determine factors associated with recall of tobacco Internet advertising, adjusting for demographics, smoking behavior variables, and receipt of tobacco industry direct mail. Participants included 3,930 adults who completed the 2001 NJATS, 4,004 adults who completed the 2002 survey, and 3,062 adults who completed the 2005 survey. The proportion of adult Internet users reporting exposure to tobacco product advertising on the Internet has increased each year (6.9% in 2001, 15.6% in 2002, 17.8% in 2005). Based on 2005 data, recall of tobacco product advertising on the Internet was higher among males young adults aged 18-24 years, Asians, adults who reported receipt of direct mail advertising, and adults with a postcollege education. In addition, adult Internet users most often reported seeing tobacco products advertised on the Internet via pop-up or banner ads (60.7%), followed by E-mail messages (24.6%), and Web sites (14.9%). Recall of tobacco advertising by Internet users increased between 2001 and 2005 and was particularly high among certain subgroups. An urgent need exists for expanded surveillance of Internet tobacco sales and marketing practices.
... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Application for industrial alcohol user permit. 20.41 Section 20.41 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS DISTRIBUTION AND USE OF DENATURED ALCOHOL AND...
Cutrona, Sarah L; Sadasivam, Rajani S; DeLaughter, Kathryn; Kamberi, Ariana; Volkman, Julie E; Cobb, Nathan; Gilbert, Gregg H; Ray, Midge N; Houston, Thomas K
Online tobacco cessation communities are beneficial but underused. Our study examined whether, among smokers participating in a web-assisted tobacco intervention (Decide2quit.org), specific characteristics were associated with navigating to BecomeAnEx.org, an online cessation community, and with subsequent quit rates. Among smokers (N = 759) registered with Decide2quit.org, we identified visitors to BecomeAnEx.org, examining associations between smoker characteristics and likelihood of visiting. We then tested for associations between visits and 6-month cessation (point prevalence). We also tested for an interaction between use of other online support-seeking (Decide2quit.org tobacco cessation coaches), visiting, and 6-month cessation. One quarter (26.0 %; n = 197) of the smokers visited BecomeAnEx.org; less than one tenth (7.5 %; n = 57) registered to participate in the online forum. Visitors were more likely to be female (73.0 vs. 62.6 % of non-visitors, P < 0.01) to have visited a cessation website before (33.0 vs. 17.4 %, P < 0.01) and to report quit attempts in the previous year (62.0 vs. 53.0 %, P = 0.03). In analyses of all participants, BecomeAnEx.org visiting was not associated with 6-month quit completion. Among participants who communicated with a coach, BecomeAnEx.org visiting also lacked a significant association with 6 month quit completion, although a non-significant trend toward quit completion in visitors was noted (OR 2.21, 95 % CI 0.81-3.1). Online cessation communities attract smokers with previous cessation website experience and recent quit attempts. Community visiting was not associated with quit rates in our study, but low use may have limited our power to detect differences. Further research should explore whether an additive effect can be achieved by offering community visitors support via online coaches.
Lee, Doohee; Turner, Nannette; Moon, Chantelle
There has been little research evaluating links between low-income populations' lifestyles and their tobacco use status. We surveyed 398 low-income individuals living in Housing Authority complexes in Columbus, Georgia. Current, former, and never tobacco users were compared for their health-related behaviors and lifestyles. Study findings suggest that current tobacco users were less healthy than comparisons, but had less unfavorable obesity measurements. In lifestyle choices, tobacco users were more likely than comparisons to be interested in sports (football, basketball, etc.), shopping, and participate in church activities.
Patel, Roshni; Kegler, Michelle C.; Brener, Nancy D.; King, Brian A.
Introduction Schools are an important environment for addressing tobacco use among youth. Tobacco-free school policies can help reduce the social acceptability of tobacco use and prevent tobacco initiation among youth. This study assessed attitudes toward tobacco-free school grounds among US adults. Methods Data came from the 2009–2010 National Adult Tobacco Survey, a telephone survey of adults aged 18 or older in the 50 US states and District of Columbia. Respondents were considered to have a favorable attitude toward tobacco-free school grounds if they reported tobacco use should be completely banned on school grounds, including fields and parking lots, and at all school events. Data were assessed using descriptive statistics and multivariable logistic regression, overall and by tobacco use status. Correlates were sex, age, race/ethnicity, education, marital status, income, sexual orientation, US region, and whether respondent lived with any children aged 17 years or younger. Results Nationally, 86.1% of adults had a favorable attitude toward tobacco-free school grounds, with larger percentages among nontobacco users (91.9%) than current users (76.1%). State prevalence ranged from 80.0% (Kentucky) to 90.9% (Washington). Overall odds of favorable attitudes were higher among nontobacco users (referent, current users), women (referent, men), and adults aged 25 or older (referent, aged 18–24); odds were lower among residents of the South (referent, West) and lesbian, gay, bisexual, or transgender adults (referent, heterosexual or straight). Conclusion Nearly 9 in 10 US adults have a favorable attitude toward tobacco-free school grounds, but attitudes vary across states and subpopulations. Opportunities exist to educate the public about the benefits of tobacco-free school grounds, which might help reduce tobacco use among youth. PMID:26719899
Popova, Lucy; Kostygina, Ganna; Sheon, Nicolas M.; Ling, Pamela M.
Cigarette companies increasingly promote novel smokeless tobacco products to smokers, encouraging them to use smokeless tobacco in smoke-free environments. New messages may counteract this promotion. We developed 12 initial anti-smokeless message ideas and tested them in eight online focus groups with 75 US smokers. Those smokers who never tried smokeless tobacco were unaware of health risks of novel smokeless tobacco products, perceived scary messages as effective and acknowledged the addictive nature of nicotine. Smokers who had tried smokeless tobacco shared their personal (mainly negative) experiences with smokeless tobacco, were aware of health risks of novel smokeless tobacco products, but denied personal addiction, and misinterpreted or disregarded more threatening messages. Portraying women as smokeless tobacco users was perceived as unbelievable, and emphasizing the lack of appeal of novel smokeless tobacco products was perceived as encouraging continued smoking. Future ads should educate smokers about risks of novel smokeless tobacco products, but past users and never users may require different message strategies. PMID:24441592
Office of Inspector General (DHHS), Washington, DC.
The study focused on non-medical steroid use by adolescents according to data obtained from the National Institute on Drug Abuse, professional literature, 30 key informants knowledgeable in steroid issues, and 72 current or former steroid users. The findings indicated: (1) over 250,000 adolescents, primarily males, used or have used steroids, and…
Primack, Brian A.; Douglas, Erika L.; Land, Stephanie R.; Miller, Elizabeth; Fine, Michael J.
Background: Media literacy programs have shown potential for reduction of adolescent tobacco use. We aimed to determine if an anti-smoking media literacy curriculum improves students' media literacy and affects factors related to adolescent smoking. Methods: We recruited 1170 9th-grade students from 64 classrooms in 3 public urban high…
Klein, David A; Adelman, William P; Thompson, Amy M; Shoemaker, Richard G; Shen-Gunther, Jane
Data examining sexuality and substance use among active duty and military-dependent youth is limited; however, these psychosocial factors have military implications. Adolescents and young adults aged 12-23 were recruited from an active-duty trainee clinic (n = 225) and a military pediatric clinic (n = 223). Active duty participants were more likely to be older, male, White, previous tobacco users, and report a history of sexual activity and less contraception use at their most recent intercourse, compared to the dependent group. Over 10% of all participants indicated attraction to members of the same gender or both genders. In logistic regression analysis, non-White participants were less likely to use contraception compared to White participants. Adolescents and young adults seen in military clinics frequently engage in high-risk behavior. Clinicians who care for military youth should assess their patient's psychosocial history. Further study of this population is warranted to identify factors that may influence risk and resilience.
Hu, Teh-wei; Lee, Anita H.
During the past decade, tobacco leaf production has shifted from high-income countries to developing countries, particularly those in Africa. Most African governments promote tobacco farming as a way to alleviate poverty. The economic benefit of tobacco farming has been used by the tobacco industry to block tobacco control policies. The tobacco industry is active in promoting the alleged positive aspects of tobacco farming and in “protecting” farmers from what they portray as unfair tobacco control regulations that reduce demand. Tobacco farming has many negative consequences for the health and wellbeing of farmers, as well as for the environment and the long-term wellbeing of the country concerned.1-3 We provide an overview of tobacco farming issues in Africa. Encompassing multi-dimensional issues of economic development, there is far more to it than tobacco control questions. PMID:25428192
Hu, Teh-wei; Lee, Anita H
During the past decade, tobacco leaf production has shifted from high-income countries to developing countries, particularly those in Africa. Most African governments promote tobacco farming as a way to alleviate poverty. The economic benefit of tobacco farming has been used by the tobacco industry to block tobacco control policies. The tobacco industry is active in promoting the alleged positive aspects of tobacco farming and in 'protecting' farmers from what they portray as unfair tobacco control regulations that reduce demand. Tobacco farming has many negative consequences for the health and well-being of farmers, as well as for the environment and the long-term well-being of the countries concerned. We provide an overview of tobacco farming issues in Africa. Encompassing multi-dimensional issues of economic development, there is far more to it than tobacco control questions.
Hatsukami, Dorothy K; Ebbert, Jon O; Edmonds, Amanda; Li, Casey; Lin, Haiying; Le, Chap; Hecht, Stephen S
This preliminary study examined the effects of tobacco-free snuff (intervention, n = 52) compared with no snuff (control, n = 54) for reducing tobacco use among smokeless tobacco (ST) users not interested in quitting. Both groups received behavioral instructions, and intervention subjects received tobacco-free snuff for 8 weeks. Participants were required to reduce their intake by 50% during the first 4 weeks and by 75% during the subsequent 4 weeks. Follow-up occurred at 12 weeks. Significant reductions were observed from baseline to week 8 (end of treatment) for both treatment groups in the amount of ST use (tins/week and dips/day, p<.001); mean urinary cotinine (p<.001); and mean urinary total NNAL, a carcinogen biomarker (p<.001). At week 8 the intervention resulted in a lower mean total NNAL (p = .048). Compared with the control condition, the intervention resulted in a higher percentage of subjects achieving at least a 50% reduction in cotinine (p = .046) and total NNAL (p = .002) at the end of treatment, more quit attempts (p = .030), and a longer mean duration of abstinence (p = .013) through follow-up. An ST reduction intervention incorporating tobacco-free snuff could potentially reduce risk for ST-related disease beyond that achieved with no snuff by increasing the number of patients who achieve significant reductions in carcinogen exposure and, more important, by facilitating tobacco abstinence by increasing quit attempts and abstinence duration.
Yuan, Menglu; Cross, Sarah J; Loughlin, Sandra E; Leslie, Frances M
Adolescence encompasses a sensitive developmental period of enhanced clinical vulnerability to nicotine, tobacco, and e-cigarettes. While there are sociocultural influences, data at preclinical and clinical levels indicate that this adolescent sensitivity has strong neurobiological underpinnings. Although definitions of adolescence vary, the hallmark of this period is a profound reorganization of brain regions necessary for mature cognitive and executive function, working memory, reward processing, emotional regulation, and motivated behavior. Regulating critical facets of brain maturation are nicotinic acetylcholine receptors (nAChRs). However, perturbations of cholinergic systems during this time with nicotine, via tobacco or e-cigarettes, have unique consequences on adolescent development. In this review, we highlight recent clinical and preclinical data examining the adolescent brain's distinct neurobiology and unique sensitivity to nicotine. First, we discuss what defines adolescence before reviewing normative structural and neurochemical alterations that persist until early adulthood, with an emphasis on dopaminergic systems. We review how acute exposure to nicotine impacts brain development and how drug responses differ from those seen in adults. Finally, we discuss the persistent alterations in neuronal signaling and cognitive function that result from chronic nicotine exposure, while highlighting a low dose, semi-chronic exposure paradigm that may better model adolescent tobacco use. We argue that nicotine exposure, increasingly occurring as a result of e-cigarette use, may induce epigenetic changes that sensitize the brain to other drugs and prime it for future substance abuse.
Accidents at nuclear power facilities seem inevitably to bring in their wake a great deal of concern on the part of both the lay and medical communities. Relatively little attention, however, is given to what may be the largest single worldwide source of effectively carcinogenic ionizing radiation: tobacco. The risk of cancer deaths from the Chernobyl disaster are tobacco smoke is discussed.
Join Together, Boston, MA.
Tobacco use remains the leading preventable cause of death in the United States, causing more than 400,000 deaths each year and resulting in an annual cost of more than $50 billion in direct medical costs. This paper provides tips and resources to help communities undertake the necessary steps to reduce tobacco use. It includes a list of national…
McCandless, Phyra M; Klausner, Kim; Taketa, Rachel; Yerger, Valerie B
Tobacco documents research has developed into a thriving academic enterprise since its inception in 1995. The technology supporting tobacco documents archiving, searching and retrieval has improved greatly since that time, and consequently tobacco documents researchers have considerably more access to resources than was the case when researchers had to travel to physical archives and/or electronically search poorly and incompletely indexed documents. The authors of the papers presented in this supplement all followed the same basic research methodology. Rather than leave the reader of the supplement to read the same discussion of methods in each individual paper, presented here is an overview of the methods all authors followed. In the individual articles that follow in this supplement, the authors present the additional methodological information specific to their topics. This brief discussion also highlights technological capabilities in the Legacy Tobacco Documents Library and updates methods for organising internal tobacco documents data and findings. PMID:21504933
Substance use is a major cause of adolescent morbidity and mortality. By age 14, 70% of adolescents have consumed alcohol and half of 12th graders report having used marijuana. The purpose of this study was to increase the understanding of parent and adolescent perceptions regarding adolescent use of alcohol, tobacco, and other drugs (ATOD) to…
Arrazola, René A; Neff, Linda J; Kennedy, Sara M; Holder-Hayes, Enver; Jones, Christopher D
Tobacco use is the leading preventable cause of disease and death in the United States, and nearly all tobacco use begins during youth and young adulthood. Among U.S. youths, cigarette smoking has declined in recent years; however, the use of some other tobacco products has increased, and nearly half of tobacco users use two or more tobacco products. CDC analyzed data from the 2013 National Youth Tobacco Survey to determine the prevalence of ever (at least once) and current (at least 1 day in the past 30 days) use of one or more of 10 tobacco products (cigarettes, cigars, hookahs, smokeless tobacco, electronic cigarettes [e-cigarettes], pipes, snus, bidis, kreteks, and dissolvable tobacco) among U.S. middle school (grades 6-8) and high school (grades 9-12) students. In 2013, 22.9% of high school students reported current use of any tobacco product, and 12.6% reported current use of two or more tobacco products; current use of combustible products (i.e., cigarettes, cigars, pipes, bidis, kreteks, and/or hookahs) was substantially greater (20.7%) than use of other types of tobacco. Also, 46.0% of high school students reported having ever tried a tobacco product, and 31.4% reported ever trying two or more tobacco products. Among middle school students, 3.1% reported current use of cigars, and 2.9% reported current use of cigarettes, with non-Hispanic black students more than twice as likely to report current use of cigars than cigarettes. Monitoring the prevalence of the use of all available tobacco products, including new and emerging products, is critical to support effective population-based interventions to prevent and reduce tobacco use among youths as part of comprehensive tobacco prevention and control programs.
Washington State Dept. of Social and Health Services, Olympia.
The 1992 Washington State Survey of Adolescent Health Behaviors (WSSAHB) was created to collect information regarding a variety of adolescent health behaviors among students in the state of Washington. It expands on two previous administrations of a student tobacco, alcohol, and other drug survey and includes questions about medical care, safety,…
Emery, S; Choi, W S; Pierce, J P
Recent longitudinal evidence suggests that approximately 34% of all new tobacco experimentation occurs because of tobacco advertising and promotions. Based on this figure, in this paper we estimate the long-term impact on mortality and morbidity, as well as the economic and medical costs associated with smoking that is attributable to cigarette advertising and promotions in the United States. This study used several data sources, including the Teenage Attitudes and Practices Survey (TAPS), the 1993 and 1996 Adolescent California Tobacco Surveys (CTS), and the Food and Drug Administration's estimates of annual illness-related benefits of alternative effectiveness rates of banning tobacco advertising. Our resulting estimates are that in each year between 1988 and 1998, tobacco advertising and promotional activities generated approximately 193000 additional adult smokers who began smoking as adolescents because of advertisements and promotions. That decade of tobacco advertising and promotions will also result in approximately 46400 smoking-attributable deaths per year and 698400 years of potential life lost, which translates into costs of approximately $21.7 billion to $33.3 billion in total medical, productivity, and mortality-related costs. Even accounting for quitting behavior, each year of advertising-attributable smoking increases the number of smokers in the population. We conclude that annual costs can be expected to continue to increase if tobacco advertising and promotional activities are not effectively eliminated. If all tobacco industry advertising and promotional activities were banned for the next 25 years, nearly 60000 smoking-attributable deaths per year could be avoided, saving nearly 900000 life-years, $2.6 billion in excess medical expenses, and between $28 billion and $43 billion in mortality costs.
Zuckerman, Karen, Ed.
This guide was designed to aid prevention specialists, educators, parents, and others in addressing tobacco problems among youth. Listed here are numerous publications--each one summarized--on tobacco use. The guide is divided into two sections: (1) Prevention Material for Tobacco; and (2) Studies, Articles, and Reports on Tobacco. Section one…
exposure. Pediatricians, their staff and colleagues, and the American Academy of Pediatrics have key responsibilities in tobacco control to promote the health of children, adolescents, and young adults.
Scherer, G.; Barkemeyer, H.
The amount of cadmium in tobacco depends on the variety and origin of the plant as well as on the analytical method used to determine cadmium. In the literature, cadmium concentrations in tobacco of between 0.5 and 5 ppm are reported. Modern German cigarette tobacco contains about 0.5-1.5 micrograms cadmium/cigarette. Of importance for the smoker is the amount of the metal in the mainstream smoke. The cadmium level in the mainstream smoke of modern cigarettes is reduced by means of filters and other construction features. The average Cd value of German filter cigarettes is less than 0.1 microgram/cigarette in mainstream smoke. An average daily intake of about 1 microgram cadmium by smoking 20 cigarettes can be calculated on the basis of an experimentally proved pulmonary retention rate of 50%. Pulmonary resorption rates relevant to uptake rates of cadmium by smoking are discussed. It can be assumed that cadmium uptake by smoking modern cigarettes has been reduced because of modifications in tobacco processing and cigarette construction in the last few decades.
Southwell, Brian G; Kim, Annice E; Tessman, Greta K; MacMonegle, Anna J; Choiniere, Conrad J; Evans, Sarah E; Johnson, Robin D
The latest generation of smokeless tobacco products encompasses a wide range of offerings, including what is commonly referred to as dissolvable tobacco. Designed to deliver nicotine upon dissolving or disintegrating in a user's mouth, dissolvable tobacco products currently appear in various United States markets as strips, orbs, sticks, and lozenges. The emergence of these new products poses distinct opportunities and challenges for social and behavioral science and public health research and raises important public policy questions.
The paper summarized briefly the evidences for tobacco use as a cause of cancer based on hundreds of epidemiologic and biomedical studies carried out over the past 50-60 years, as well as overviewed the carcinogens in tobacco products and mechanisms of neoplasm induction by tobacco products. So, tobacco control is the important measure for cancer prevention.
Whittamore, Kathy; Britton, John; Leonardi-Bee, Jo
Abstract To determine the extent to which video games include alcohol and tobacco content and assess the association between playing them and alcohol and smoking behaviors in adolescent players in Great Britain. Assessment of substance in the 32 UK bestselling video games of 2012/2013; online survey of adolescent playing of 17 games with substance content; and content analysis of the five most popular games. A total of 1,094 adolescents aged 11–17 years were included as participants. Reported presence of substance content in the 32 games; estimated numbers of adolescents who had played games; self-reported substance use; semiquantitative measures of substance content by interval coding of video game cut scenes. Nonofficial sources reported substance content in 17 (44 percent) games but none was reported by the official Pan European Game Information (PEGI) system. Adolescents who had played at least one game were significantly more likely ever to have tried smoking (adjusted odds ratio [OR] 2.70, 95 percent confidence interval [CI] 1.75–4.17) or consumed alcohol (adjusted OR 2.35, 95 percent CI 1.70–3.23). In the five most popular game episodes of alcohol actual use, implied use and paraphernalia occurred in 31 (14 percent), 81 (37 percent), and 41 (19 percent) intervals, respectively. Tobacco actual use, implied use, and paraphernalia occurred in 32 (15 percent), 27 (12 percent), and 53 (24 percent) intervals, respectively. Alcohol and tobacco content is common in the most popular video games but not reported by the official PEGI system. Content analysis identified substantial substance content in a sample of those games. Adolescents who play these video games are more likely to have experimented with tobacco and alcohol. PMID:27428030
Cranwell, Jo; Whittamore, Kathy; Britton, John; Leonardi-Bee, Jo
To determine the extent to which video games include alcohol and tobacco content and assess the association between playing them and alcohol and smoking behaviors in adolescent players in Great Britain. Assessment of substance in the 32 UK bestselling video games of 2012/2013; online survey of adolescent playing of 17 games with substance content; and content analysis of the five most popular games. A total of 1,094 adolescents aged 11-17 years were included as participants. Reported presence of substance content in the 32 games; estimated numbers of adolescents who had played games; self-reported substance use; semiquantitative measures of substance content by interval coding of video game cut scenes. Nonofficial sources reported substance content in 17 (44 percent) games but none was reported by the official Pan European Game Information (PEGI) system. Adolescents who had played at least one game were significantly more likely ever to have tried smoking (adjusted odds ratio [OR] 2.70, 95 percent confidence interval [CI] 1.75-4.17) or consumed alcohol (adjusted OR 2.35, 95 percent CI 1.70-3.23). In the five most popular game episodes of alcohol actual use, implied use and paraphernalia occurred in 31 (14 percent), 81 (37 percent), and 41 (19 percent) intervals, respectively. Tobacco actual use, implied use, and paraphernalia occurred in 32 (15 percent), 27 (12 percent), and 53 (24 percent) intervals, respectively. Alcohol and tobacco content is common in the most popular video games but not reported by the official PEGI system. Content analysis identified substantial substance content in a sample of those games. Adolescents who play these video games are more likely to have experimented with tobacco and alcohol.
The use of tobacco in any form is a major preventable cause of premature death and disease. Globally, nearly 5 million persons die every year from tobacco-related illnesses, with disproportionately higher mortality occurring in developing countries. The Global Youth Tobacco Survey (GYTS), initiated in 1999 by the World Health Organization (WHO), CDC, and the Canadian Public Health Association, is a school-based survey that includes questions on prevalence of cigarette and other tobacco use; attitudes toward tobacco; access to tobacco products; exposure to secondhand smoke, school curricula on tobacco, media, and advertising; and smoking cessation. This report presents estimates of self-reported cigarette and other tobacco-product use during 1999-2005 in 132 different countries and the Gaza Strip/West Bank. The data are aggregated within each of the six WHO regions. GYTS data indicate that nearly two of every 10 students reported currently using a tobacco product, with no statistically significant difference between the proportion of those reporting cigarette smoking (8.9%) and other tobacco use (11.2%). Use of tobacco by adolescents is a major public health problem in all six WHO regions. Worldwide, more countries need to develop, implement, and evaluate their tobacco-control programs to address the use of all types of tobacco products, especially among girls.
Stojiljkovic, Djorde; Haralanova, Maria; Nikogosian, Haik; Petrea, Ionela; Chauvin, James; Warren, Charles W.; Jones, Nathan R.; Asma, Samira
Objective: To examine adolescent tobacco use among members of the South-Eastern Europe (SEE) Health Network using data from the Global Youth Tobacco Survey (GYTS). Methods: Nationally representative samples were drawn from students in grades associated with youth aged 13 to 15 in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, the Former…
Payne, Thomas J; Chen, Chieh-I; Baker, Christine L; Shah, Sonali N; Pashos, Chris L; Boulanger, Luke
Tobacco use remains the leading cause of preventable death. The outpatient medical clinic represents an important venue for delivering evidence-based interventions to large numbers of tobacco users. Extensive evidence supports the effectiveness of brief interventions. In a retrospective database analysis of 11,827 adult patients captured in the 2005 National Ambulatory Medical Care Survey (of which 2,420 were tobacco users), we examined the degree to which a variety of patient demographic, clinical and physician-related variables predict the delivery of tobacco counseling during a routine outpatient visit in primary care settings. In 2005, 21.7% of identified tobacco users received a tobacco intervention during their visit. The probability of receiving an intervention differed by gender, geographic region and source of payment. Individuals presenting with tobacco-related health conditions were more likely to receive an intervention. Most physicians classified as specialists were less likely to intervene. The provision of tobacco intervention services appears to be increasing at a modest rate, but remains well below desirable levels. It is a priority that brief interventions be routinely implemented to reduce the societal burden of tobacco use.
Lauterstein, Dana; Hoshino, Risa; Gordon, Terry; Watkins, Beverly-Xaviera; Weitzman, Michael; Zelikoff, Judith
Tobacco use, primarily in the form of cigarettes, is the leading cause of preventable morbidity and mortality in the United States (U.S.). The adverse effects of tobacco use began to be recognized in the 1940’s and new hazards of active smoking and secondhand smoke (SHS) exposure from cigarettes continue to be identified to this day. This has led to a sustained and wide-ranging array of highly effective regulatory, public health, and clinical efforts that have been informed by extensive scientific data, resulting in marked decreases in the use of cigarettes. Unfortunately, the dramatic recent decline in cigarette use in the U.S., has been accompanied by an upsurge in adolescent and young adult use of new, non-cigarette tobacco and nicotine-delivery products, commonly referred to as alternative tobacco products (ATPs). Commonly used ATPs include hookah, cigars, smokeless tobacco, and electronic cigarettes. While there have been a number of review articles that focus on adult ATP use, the purpose of this review is to provide an overview of what is, and is not known about emerging ATP use among U.S. adolescents on a national scale; as well as to identify research gaps in knowledge, and discuss future health and policy needs for this growing public health concern. This paper is not meant to systemically review all published survey data, but to present clear depiction of selected ATP usage in youth populations using national survey data. PMID:25323124
Cohn, Amy M; Ehlke, Sarah J; Cobb, Caroline O; Soule, Eric K
Hookah tobacco smoking (HTS) has been increasing, particularly among young adults and has similar health effects compared to cigarette smoking. The link between HTS and poly-tobacco use is well documented, but fewer show an association between HTS and alcohol use. It is essential to identify factors that increase the risk for or addictiveness and consequences of HTS, given its growing prevalence. This study examined whether the association between HTS and poly-tobacco use differed as a function of age and alcohol consumption within in a sample of 1223 adult cigarette smokers. Approximately 20% of participants reported HTS. Compared to non-users, hookah users were more likely to be male, highly educated, and to report drug and alcohol use, binge drinking, and poly-tobacco use but were less likely to be heavy smokers (≥10 cigarettes per day). Regression analyses predicting number of tobacco products used (excluding cigarettes and HTS) indicated a three-way interaction of HTS, frequency of alcohol use, and age such that the association between HTS and number of tobacco products used was strongest for younger respondents who consumed alcohol more frequently. As observed in previous studies, alcohol is an important risk factor in the relationship between HTS and poly-tobacco use, particularly among younger cigarette smokers. The links between alcohol, HTS, and poly-tobacco use should be considered when developing HTS education and prevention materials directed toward younger cigarette smokers. Findings provide information relevant to FDA's interest in the addiction potential of HTS and its link to poly-tobacco use.
Connolly, G N
As smoking rates fall in North America and western Europe, transnational tobacco companies (TTCs) from the United States and Great Britain turn to cigarette markets of the developing world to replace those smokers who have quit or died from smoking. The majority of these markets are dominated by state tobacco monopolies that advertise and promote smoking minimally. Few women or adolescents smoke in those nations. The majority of men do, but they smoke far fewer cigarettes per year than their counterparts in developed nations. Trade barriers in the developing world prevent foreign cigarette companies from entering. TTCs employ various techniques to force open those markets, including trade pressure from the US government. Once the market is open, Western cigarette advertising and promotions target nonsmoking women and children. Retail tobacco outlets increase, smoking rates rise, and more death and disease result. Latin America was the TTC target in the 1960s, the newly developed nations of Asia during the 1980s, and, today, the tobacco giants are pushing into eastern Europe, China, and Africa. If nothing is done, emerging national smoking-control programs will be overwhelmed, and state-owned cigarette monopolies will be taken over by the TTCs. Policies and programs to curb smoking exist, but for various reasons many lesser developed countries have not adopted them. The threat of TTC entry into a closed market offers an opportunity to form national coalitions against smoking, educate the public about the dangers of tobacco use, and implement public health policies and programs to restrict marketing and use of cigarettes.(ABSTRACT TRUNCATED AT 250 WORDS)
Khariwala, Samir S.; Garg, Apurva; Stepanov, Irina; Gupta, Prakash C.; Ahluwalia, Jasjit S.; Gota, Vikram; Chaturvedi, Pankaj
Objectives In India, a 2003 law (“COPTA”) banned tobacco advertising with the exception of “point of sale” and “on-pack” advertising. Given substantial evidence regarding the impact of point of sale advertising (PoS), we analyzed the prevalence of encountering such advertising in Mumbai, India. Methods A survey was conducted of 199 current and recent former tobacco users recruited at the Tata Memorial Hospital (Mumbai). Enrollees were queried regarding their exposure to tobacco advertising in the last 30 days through multiple media sources. Descriptive epidemiologic techniques were used to characterize the data. Results Overall, 95% of participants were men and 5% were women (mean age=49 years). All were current tobacco users or quit using all forms of tobacco in the last 60 days. Participants’ responses revealed that PoS tobacco advertising had been encountered in the last 30 days for cigarettes (61%), bidis (54%), and smokeless tobacco (59%). Other forms of tobacco advertising were virtually non-existent. Conclusions PoS tobacco advertising remains prominent and highly visible to consumers in Mumbai, India, indicating corporate exploitation of a loophole in the COPTA legislation. Given the observed compliance with the currently imposed bans, revisions of COPTA to include all forms of tobacco promotion and advertising would be impactful. PMID:28217721
Abbas, S M; Alam, A Y; Usman, M; Siddiqi, K
Smokeless tobacco is commonly used in south Asia. In addition to causing oral and pharyngeal cancers, its harmful effects are comparable to smoking tobacco. A cross-sectional survey with systematic sampling was conducted in 2010-2011 to investigate smokeless tobacco use in a multi-ethnic, semi-urban population in Islamabad, Pakistan (n = 2030). The prevalence of smokeless tobacco use was 16.0% (21.6% among males and 8.8% among females); 51.7% of smokeless tobacco users were also cigarette smokers. The rate of smokeless tobacco use was comparatively high among Pakhtun males (38.2%) and Sindhi females (22.4%). The associations between smokeless tobacco use and ethnicity, age group, income level and cigarette smoking were statistically significant among male smokeless tobacco users. Of the sample 41.4% (840/2030) had inadequate knowledge about the health problems associated with smokeless tobacco. Appropriate interventions are needed to raise awareness of the health risks and to prevent smokeless tobacco use.
Thrasher, J; Niederdeppe, J; Farrelly, M; Davis, K; Ribisl, K; Haviland, M
Background: Adolescents who live in tobacco producing regions may not respond favourably to anti-industry ads. Objective: To examine whether state level involvement in tobacco production appears to limit the effectiveness of anti-industry ads to prevent tobacco use among adolescents in the USA. Design: Time trend analyses were done using repeated cross sectional data from six waves of the Legacy Media Tracking Survey, which were collected between 1999 and 2003. Setting and participants: 28 307 adolescents, ages 12–17 years, were classified as living in: tobacco producing states (TPS) (n = 1929); non-tobacco producing states (non-TPS) with low tobacco control funding comparable to TPS (n = 5323); non-TPS with relatively high funding (n = 15 076); and non-TPS with established anti-industry ad campaigns (n = 5979). Main outcome measures: Reactions to anti-industry ads; strength of anti-industry attitudes/beliefs; changes in anti-industry attitudes/beliefs over time. Results: Ad reactions did not differ by state type. Multivariate adjusted time trend analyses indicated significant, comparable increases in anti-industry attitudes/beliefs since the onset of the truth® campaign, in both TPS and non-TPS. Mediation analyses indicated that these increases were due, in part, to campaign exposure. Conclusions: Adolescents who live in tobacco producing regions appear to be as responsive to anti-industry ads as their counterparts in non-tobacco producing regions. This study provides further evidence for the effectiveness of such ads. PMID:15333885
Bierer, M F; Rigotti, N A
Public policies concerning tobacco shape the environment of the smoker and nonsmoker alike. These policies use diverse means to achieve the common goal of reducing tobacco use and its attendant health consequences. Educational interventions such as warning labels, school curricula, and public service announcements serve to inform the public about the hazards of tobacco smoke. These are countered by the pervasive marketing of tobacco products by the tobacco industry, despite a ban on tobacco advertising on radio and television. Further restrictions on tobacco advertising and promotion have been proposed and await action. Cigarette excise taxes and smoker-nonsmoker insurance premium differentials discourage smoking by making it more costly to purchase cigarettes. Conversely, health insurance reimbursement for smoking cessation programs could reduce the cost of giving up the habit and might encourage cessation. Restricting or banning smoking in public places and workplaces decreases a smoker's opportunities to smoke, further inhibiting this behavior. Reducing the availability of cigarettes to children and adolescents may help to prevent them from starting to smoke. The environment of the smoker is conditioned by this pastiche of influences. Physicians who become involved in tobacco-control issues have the opportunity to alter the environmental influences on their patients. This is likely to be synergistic with physicians' efforts inside the office to encourage individual smokers to quit. As a first step toward advocacy outside the office, physicians can help to create a smoke-free health-care facility in their own institution. Beyond that, advocacy groups or the voluntary health organizations (e.g., American Lung Association) provide avenues for physicians to take a stand on community issues relevant to tobacco control. Physicians who take these steps to alter the environment of smokers beyond the office are likely to magnify the effect of their work with individual
... People in many regions and countries, including North America, northern Europe, India and other Asian countries, and parts of Africa, have a long history of using smokeless tobacco products. There are two ...
... this page: //medlineplus.gov/ency/article/002032.htm Risks of tobacco To use the sharing features on ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...
... the tobacco use on TV and in movies, music videos, billboards and magazines–most teens, adults, and ... Early and Often Despite the impact of movies, music, and TV, parents can be the GREATEST INFLUENCE ...
... carbon dioxide, carbon monoxide, propane, methane, acetone, hydrogen cyanide and various carcinogens. Other chemicals that are associated with chewing or sniffing tobacco include aniline, naphthalene, phenol, pyrene, tar, and 2- ...
Ibrahim, J K; Glantz, Stanton A
Objective To document the tobacco industry's litigation strategy to impede tobacco control media campaigns. Methods Data were collected from news and reports, tobacco industry documents, and interviews with health advocates and media campaign staff. Results RJ Reynolds and Lorillard attempted to halt California's Media Campaign alleging that the campaign polluted jury pools and violated First Amendment rights because they were compelled to pay for anti‐industry ads. The American Legacy Foundation was accused of violating the Master Settlement Agreement's vilification clause because its ads attacked the tobacco industry. The tobacco companies lost these legal challenges. Conclusion The tobacco industry has expanded its efforts to oppose tobacco control media campaigns through litigation strategies. While litigation is a part of tobacco industry business, it imposes a financial burden and impediment to media campaigns' productivity. Tobacco control professionals need to anticipate these challenges and be prepared to defend against them. PMID:16436406
Good science needs good measurement instruments, and this is also true for the study of tobacco dependence. In this paper, we present and criticize the most frequently used instrument, the Fagerström Test for Nicotine Dependence. This test, published 28 years ago, does not reflect current definitions of dependence. Several alternative approaches to the measurement of tobacco dependence are discussed, and more recent instruments are presented.
Tomar, S L; Giovino, G A
OBJECTIVES: The purpose of this study was to provide estimates of the cumulative incidence of initiation of smokeless tobacco use in a cohort of young persons and to explore sociodemographic, environmental, behavioral, and personal predictors of experimentation with and regular use of snuff or chewing tobacco. METHODS: The data for this cohort study were derived from the 1989 Teenage Attitudes and Practices Survey and its 1993 follow-up. The study included 7830 young people 11 through 19 years of age at baseline. RESULTS: During the 4 years, 12.7% of participants (20.9% of male participants) first tried smokeless tobacco, and 4.0% (8.0% of male participants) became self-classified regular users. This suggests that, each year, approximately 824000 young people in the United States 11 to 19 years of age experiment with smokeless tobacco and about 304 000 become regular users. Cumulative incidence was highest for male non-Hispanic Whites. Predictors of regular use included age, geographic region, cigarette smoking, participation in organized sports, and perceived friends' approval or indifference. CONCLUSIONS: Public health approaches to preventing use of smokeless tobacco should include development of skills for responding to pressures to use tobacco. PMID:9584028
Strasburger, Victor C
The causes of adolescent substance use are multifactorial, but the media can play a key role. Tobacco and alcohol represent the 2 most significant drug threats to adolescents. More than $25 billion per year is spent on advertising for tobacco, alcohol, and prescription drugs, and such advertising has been shown to be effective. Digital media are increasingly being used to advertise drugs. In addition, exposure to PG-13- and R-rated movies at an early age may be a major factor in the onset of adolescent tobacco and alcohol use. The American Academy of Pediatrics recommends a ban on all tobacco advertising in all media, limitations on alcohol advertising, avoiding exposure of young children to substance-related (tobacco, alcohol, prescription drugs, illegal drugs) content on television and in PG-13- and R-rated movies, incorporating the topic of advertising and media into all substance abuse-prevention programs, and implementing media education programs in the classroom.
McNeill, Ann; Hammond, David; Gartner, Coral
Despite decades of industry innovation and regulatory efforts, the harmfulness of conventional cigarettes has not changed. There are several pitfalls in this area, including the long time lag before health impacts of product regulatory changes become apparent, the danger of consumers deriving false reassurance of lesser harm in the interim period, the lack of relevant expertise and the lack of an internationally agreed and evidence-based strategic approach. Articles 9 and 10 of the Framework Convention on Tobacco Control provide the potential for such a global strategy, and knowledge and research has increased significantly over recent years. However, there are huge opportunity costs in implementing product disclosure and regulatory strategies: most national regulators have very limited human and financial resources, which should be focused on other evidence-based tobacco control interventions. We believe therefore that it is now time to abandon the notion of safe or safer cigarettes while moving consumers towards cleaner nicotine products as soon as possible. In parallel to this, we recommend a number of other strategies be implemented including: reducing the appeal of all tobacco products, forbidding new tobacco products or brand variants being marketed without evidence of reduced harm, appeal or addictiveness, and developing a tobacco industry resourced, but industry independent, Framework Convention on Tobacco Control global repository to assist national regulators in understanding and regulating the products on their markets.
Kowitt, Sarah D.; Sutfin, Erin L.; Patel, Tanha; Ranney, Leah M.; Goldstein, Adam O.
Introduction Although adolescent cigarette use continues to decline in the United States, electronic cigarette (e‑cigarette) use among adolescents has escalated rapidly. This study assessed trends and patterns of e‑cigarette use and concurrent cigarette smoking and the relationships between e-cigarette use and smoking cessation intentions and behaviors among high school students in North Carolina. Methods Data came from high school students who completed the school-based, cross-sectional North Carolina Youth Tobacco Survey in 2011 (n = 4,791) and 2013 (n = 4,092). This study assessed changes in prevalence of e-cigarette and cigarette use from 2011 through 2013, and cessation-related factors associated with those students’ current and past use of e‑cigarettes in 2013. Results The prevalence of current e-cigarette use (use in the past 30 days) significantly increased from 1.7% (95% CI, 1.3%–2.2%) in 2011 to 7.7% (95% CI, 5.9%–10.0%) in 2013. Among dual users, current e-cigarette use was negatively associated with intention to quit cigarette smoking for good (relative risk ratio [RRR] = 0.51; 95% CI, 0.29–0.87) and with attempts to quit cigarette smoking in the past 12 months (RRR = 0.69; 95% CI, 0.49–0.97). Current e-cigarette smokers were less likely than those who only smoked cigarettes to have ever abstained from cigarette smoking for 6 months (RRR = 0.42; 95% CI, 0.21–0.82) or 1 year (RRR = 0.21; 95% CI, 0.09–0.51) and to have used any kind of aids for smoking cessation (RRR = 0.46; 95% CI, 0.29–0.74). Conclusion Public health practitioners and cessation clinic service providers should educate adolescents about the risks of using any nicotine-containing products, including e-cigarettes, and provide adequate tobacco cessation resources and counseling to adolescent tobacco users. PMID:27490368
Hall, W; Gartner, C
In Sweden, male cigarette smoking has declined as snus, a smokeless tobacco product which is low in carcinogenic nitrosamines, has gained popularity among male tobacco users. Epidemiological modelling based on the Swedish experience indicates that there would be major public health gains if a substantial number of current smokers in other countries could also be persuaded to switch to this product. This form of 'tobacco harm reduction' is very controversial in the public health community for many reasons. These include: objections in principle to the use of less harmful but still addictive nicotine products; uncertainties about the long-term effects of these products on health; doubts about the likely interest in and uptake of these products among existing smokers; concerns that increasing the availability of these products will increase the number of new tobacco users and eventually the number of smokers in the population; and anxiety about how the tobacco industry may use these products to undermine current tobacco control policies. This paper concludes with suggestions for a graduated series of policies that may allow exploration of the public health costs and benefits of encouraging smokers to switch to snus.
Freeman, Becky; Chapman, Simon
With the increased reach of Web 2.0, Internet users expect webpages to be interactive. No studies have been conducted to assess whether tobacco control-relevant sites have implemented these features. The authors conducted an analysis of an international sample of tobacco control-relevant websites to determine their level of interactivity. The sample included 68 unique websites selected from Google searches in 5 countries, on each country's Google site, using the term smoking. The 68 sites were analyzed for 10 categories of interactive tools. The most common type of interactive content found on 46 (68%) of sites was for multimedia featuring content that was not primarily text based, such as photo galleries, videos, or podcasts. Only 11 (16%) websites-outside of media sites-allowed people to interact and engage with the site owners and other users by allowing posting comments on content and/or hosting forums/discussions. Linkages to social networking sites were low: 17 pages (25%) linked to Twitter, 15 (22%) to Facebook, and 11 (16%) to YouTube. Interactivity and connectedness to online social media appears to still be in its infancy among tobacco control-relevant sites.
... HUMAN SERVICES Food and Drug Administration Guidance for Tobacco Retailers on Tobacco Retailer Training... ``Tobacco Retailer Training Programs.'' The Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) does not require retailers to implement retailer training programs. However, the...
Adil, Abo-mali; Mustafa, Babiker M.; Abdo, Hussein
Tobacco is the single most important cause of chronic morbidity in the Developed World. Tobacco use primarily begins in early adolescence, reportedly before the time of high school graduation. By 2015 tobacco use is projected to cause 50% more deaths than AIDS. A cross sectional school based survey was conducted in primary and secondary school in Khartoum State. The study aimed to estimate the prevalence of smoking in school adolescents and associated personal and social factors. A total of 910 students with complete questionnaires were included in the analysis, of whom 13.6% were found to be current cigarette smokers. Factors that played role in initiation of smoking included smoking among parents, other family members and close friends. School adolescents who have friends or parents who smoke should be the main target for tobacco control. Smoking should become public health priority in Sudan to educate adolescents and parents regarding its hazards. PMID:27493344
Morrison, Margaret A.; Krugman, Dean M.; Park, Pumsoon
Objectives. In light of the Smokeless Tobacco Master Settlement Agreement (STMSA) and the fact that smokeless tobacco advertising has received little attention, we examined industry data to assess smokeless tobacco advertising in popular magazines. Of particular interest was the level of advertising in magazines with high youth readership and the amount of reach and frequency that was generated among readers aged 12 to 17 years. Methods. We used readership data from Mediamark Research Inc, advertising expenditure data from TNS Media Intelligence, and Adplus, a media planning program from Telmar to document the composition of adult and youth readership of magazines in which smokeless tobacco products were advertised, industry expenditures on advertising, and adolescents’ exposure to smokeless tobacco advertising. Results. The STMSA appears to have had a limited effect on the advertising of smokeless tobacco products to youth; both before and after the agreement, smokeless tobacco companies advertised in magazines with high adolescent readership. Conclusions. Popular magazines with smokeless tobacco advertising reach a large number of adolescents through a combination of both youth-oriented and adult magazines. These exposure levels have generally increased since the STMSA. PMID:17600263
McNeill, A; Bedi, R; Islam, S; Alkhatib, M N; West, R
Objective This study examined the constituents of smokeless tobacco products available in the UK and compared them with products available in India, Sweden, and the USA Methods Seven UK brands of smokeless tobacco, including a tooth cleaning powder, and four international brands of smokeless tobacco were tested for a range of toxins and known carcinogens, such as tobacco specific N‐nitrosamines (TSNA), as well as nicotine availability. Results Ten of the 11 brands tested had detectable levels of tobacco specific nitrosamines, which are proven carcinogens, and levels varied 130‐fold. All had detectable levels of benzo(a)pyrene, another proven carcinogen (with around 175‐fold variation) and several toxic metals (with nearly 150‐fold variation). Nicotine availability varied in the UK products from 0.1 mg/g to 63.2 mg/g. All the tobacco products tested are likely to be hazardous to users' health, but the data indicate that it should be possible to reduce key toxins to non‐detectable levels. Conclusions Smokeless tobacco products should be regulated and standards set for maximum levels of toxins and carcinogens. PMID:16436408
In efforts to control diseases it is common to look at ways to control the vectors of disease. When dealing with tobacco-caused disease this requires an understanding of the companies that manufacture and market tobacco products, and an examination of how to shape the behaviour of these companies. Since these corporations are created by law, and seek to maximize value for their owners within the constraints that laws place on the marketplace, it is only natural that a very significant part of tobacco control activities will consist of legal strategies. This paper identifies the underlying public health goal of tobacco control activities as being the reduction of death and disease. It then considers the roles that prevention, cessation, protection from environmental tobacco smoke and toxicity reduction can play as overall strategies for achieving this goal. This is followed by the identification of a broad range of legal strategies, primarily emphasizing governmental regulation, that can be used as part of these overall strategies. The paper looks specifically at a range of measures that impact on the accessibility of tobacco products, the provision of information for consumers, protection of the health and rights of non-users and the significant potential health gains from regulation of tobacco products.
Pearson, Jennifer; Xiao, Haijun; Stalgaitis, Carolyn; Vallone, Donna
Objectives. We provided estimates of noncombustible tobacco product (electronic nicotine delivery systems [ENDS]; snus; chewing tobacco, dip, or snuff; and dissolvables) use among current and former smokers and examined harm perceptions of noncombustible tobacco products and reasons for their use. Methods. We assessed awareness of, prevalence of, purchase of, harm perceptions of, and reasons for using noncombustible tobacco products among 1487 current and former smokers from 8 US designated market areas. We used adjusted logistic regression to identify correlates of noncombustible tobacco product use. Results. Of the sample, 96% were aware of at least 1 noncombustible tobacco product, but only 33% had used and 21% had purchased one. Noncombustible tobacco product use was associated with being male, non-Hispanic White, younger, and more nicotine dependent. Respondents used noncombustible tobacco products to cut down or quit cigarettes, but only snus was associated with a higher likelihood of making a quit attempt. Users of noncombustible tobacco products, particularly ENDS, were most likely to endorse the product as less harmful than cigarettes. Conclusions. Smokers may use noncombustible tobacco products to cut down or quit smoking. However, noncombustible tobacco product use was not associated with a reduction in cigarettes per day or cessation. PMID:24922154
Evidence of the causal role of marketing in the tobacco epidemic and the advent of the WHO Framework Convention on Tobacco Control have inspired more than half the countries in the world to ban some forms of tobacco marketing. This paper briefly describes the ways in which cigarette marketing is restricted and the tobacco industry's efforts to subvert restrictions. It reviews what is known about the impact of marketing regulations on smoking by adults and adolescents. It also addresses what little is known about the impact of marketing bans in relation to concurrent population-level interventions, such as price controls, anti-tobacco media campaigns and smoke-free laws. Point of sale is the least regulated channel and research is needed to address the immediate and long-term consequences of policies to ban retail advertising and pack displays. Comprehensive marketing restrictions require a global ban on all forms of promotion, elimination of packaging and price as marketing tools, and limitations on the quantity, type and location of tobacco retailers.
Evidence of the causal role of marketing in the tobacco epidemic and the advent of the WHO Framework Convention on Tobacco Control have inspired more than half the countries in the world to ban some forms of tobacco marketing. This paper briefly describes the ways in which cigarette marketing is restricted and the tobacco industry's efforts to subvert restrictions. It reviews what is known about the impact of marketing regulations on smoking by adults and adolescents. It also addresses what little is known about the impact of marketing bans in relation to concurrent population-level interventions, such as price controls, anti-tobacco media campaigns and smoke-free laws. Point of sale is the least regulated channel and research is needed to address the immediate and long-term consequences of policies to ban retail advertising and pack displays. Comprehensive marketing restrictions require a global ban on all forms of promotion, elimination of packaging and price as marketing tools, and limitations on the quantity, type and location of tobacco retailers. PMID:22345238
Objective: To identify and explain tobacco industry strategy in undermining tobacco control measures in Finland and results of these interferences in tobacco policy development during the 1980s and early 1990s. Methods: Tobacco industry documents, which have been publicly available on the internet as a result of litigation in the USA, were analysed. Documents were sought by Finland and by names of organisations and tobacco control activists. Documents were accessed and assessed between September 2000 and November 2002. Tactics of the tobacco industry activities were categorised as presented by Saloojee and Dagli. Results: The international tobacco companies utilised similar strategies in Finland as in other industrial markets to fight tobacco control and legislation, the health advocacy movement, and litigation. These activities slowed down the development and implementation of the Tobacco Act in Finland. However, despite the extensive pressure, the industry was not able to prevent the most progressive tobacco legislation in Europe from being passed and coming into force in Finland in 1977 and in 1995. Conclusion: Denying the health hazards caused by tobacco—despite indisputable scientific evidence—decreased the credibility of the tobacco industry. Strategy of denial was falsely chosen, as health advocacy groups were active both in society and the parliamentary system. The strong influence of the tobacco industry may have in fact increased the visibility of tobacco control in Finland as the litigation process was also drawing attention to negative health effects of tobacco. Therefore the tobacco industry did not manage to convince public opinion. However, the tobacco industry did obtain experience in Finland in how to object to tobacco control measures. PMID:14660780
Imam, Sardar Z; Nawaz, Haq; Sepah, Yasir J; Pabaney, Aqueel H; Ilyas, Mahwish; Ghaffar, Shehzad
Background Use of smokeless tobacco is common in South Asia. Tobacco is a major preventable cause of morbidity and mortality. Doctors make one of the best avenues to influence patients' tobacco use. However, medical students addicted to tobacco are likely to retain this habit as physicians and are unlikely to counsel patients against using tobacco. With this background, this study was conducted with the objective of determining the prevalence of smokeless tobacco among Pakistani medical students. Methods A cross sectional study was carried out in three medical colleges of Pakistan – one from the north and two from the southern region. 1025 students selected by convenient sampling completed a peer reviewed, pre-tested, self-administered questionnaire. Questions were asked regarding lifetime use (at least once or twice in their life), current use (at least once is the last 30 days), and established use (more than 100 times in their life) of smokeless tobacco. Chi square and logistic regression analyses were used. Results Two hundred and twenty (21.5%) students had used tobacco in some form (smoked or smokeless) in their lifetime. Sixty six (6.4%) students were lifetime users of smokeless tobacco. Thirteen (1.3%) were daily users while 18 (1.8%) fulfilled the criterion for established users. Niswar was the most commonly used form of smokeless tobacco followed by paan and nass. Most naswar users belonged to NWFP while most paan users studied in Karachi. On univariate analysis, lifetime use of smokeless tobacco showed significant associations with the use of cigarettes, student gender (M > F), student residence (boarders > day scholars) and location of the College (NWFP > Karachi). Multivariate analysis showed independent association of lifetime use of smokeless tobacco with concomitant cigarette smoking, student gender and location of the medical college. Conclusion The use of smokeless tobacco among medical students cannot be ignored. The governments should add the
Kennedy, Sara M.; Patel, Roshni P.; Cheh, Paul; Hsia, Jason; Rolle, Italia V.
Introduction African American youth use marijuana at similar rates and tobacco at lower rates compared with white youth; however, in adulthood, tobacco use is similar. Tobacco and marijuana use are closely associated; differing initiation patterns may contribute to observed racial differences in tobacco prevalence by age. Therefore, it is important to assess tobacco and marijuana initiation patterns by race. Methods Data were obtained from 56,555 adults aged 18–25 who completed the 2005–2012 National Survey on Drug Use and Health. The analysis was restricted to those who reported ever use of marijuana and combustible tobacco (cigarettes and/or cigars). Three mutually exclusive categories of initiation patterns were evaluated: use of marijuana before tobacco; marijuana and tobacco at the same age; and tobacco before marijuana. Multivariable regression models were used to assess changes over time and compare these outcomes by race while controlling for sociodemographics, risk perceptions, and current substance use. Results In 2005, 26.6% of African American and 14.3% of white young adults used marijuana before tobacco, compared with 41.5% of African American and 24.0% of white young adults in 2012 (P < .001). Overall, African American young adults had greater odds of using marijuana before tobacco (AOR = 1.79; 95% CI: 1.67, 1.91) compared with whites. Conclusion African American young adults were more likely than whites to use marijuana before tobacco and both groups were increasingly likely to use marijuana before tobacco over time. A greater understanding of how marijuana initiation interacts with tobacco initiation could inform more effective tobacco and marijuana use prevention efforts. Implications Among ever users of combustible tobacco and marijuana, greater proportions of African American young adults used marijuana before tobacco or at the same age than their white counterparts. Moreover, both African Americans and whites were more likely to use
Seo, Dong-Chul; Torabi, Mohammad R.; Weaver, Amy E.
Background: To investigate the correlates of youth tobacco use in terms of nonsmoking adolescents' openness to future smoking, a secondary analysis of the 2000 and 2004 Indiana Youth Tobacco Survey (IYTS) was conducted. Methods: A representative sample of 1416 public high school students in grades 9-12 and 1516 public middle school students in…
Hahn, Ellen J; Rayens, Mary Kay; Rasnake, Rob; York, Nancy; Okoli, Chizimuzo T C; Riker, Carol A
This study examined factors associated with tobacco-free policies and tobacco cessation in schools serving children in grades 6 to 12 in a tobacco-growing state using a cross-sectional telephone survey of school administrators from public and private middle and high schools (N = 691), representing 117 of the 120 Kentucky counties. Trained health department staff contacted 1028 schools; 691 (67%) participated in a phone survey, which lasted an average of 19 minutes. Variables of interest were indoor and outdoor smoking policies, fund-raising in Bingo halls, provision of cessation and prevention programs, owning or leasing a tobacco base, if the school received money from tobacco companies, type of school (public vs private), and school setting (urban vs rural). Only 20% of Kentucky schools reported comprehensive tobacco-free policies. Urban area schools were nearly twice as likely to have a tobacco-free campus than rural schools. Schools that did fund-raising in smoky Bingo halls were 30% less likely to have tobacco-free school policies. While few schools had a tobacco affiliation, those that received money from tobacco companies or grew tobacco were nearly 3 times as likely to provide cessation resources, compared to schools without tobacco affiliation. Rural schools were less likely to be tobacco free and provide cessation services. School-related, off-campus, extracurricular events might be considered as an element of tobacco-free school policy. Schools with tobacco affiliation may provide more cessation resources due to the increased prevalence of tobacco use in these areas.
Myhr, Kjell-Morten; Holmøy, Trygve; Benth, Jūratė Šaltytė; Løken-Amsrud, Kristin I.; Wergeland, Stig; Beiske, Antonie G.; Bjerve, Kristian S.; Hovdal, Harald; Lilleås, Finn; Midgard, Rune; Pedersen, Tom; Bakke, Søren J.; Torkildsen, Øivind
Objective: To study whether tobacco use is associated with MRI and clinical disease activity in patients with multiple sclerosis (MS). Methods: Prospective cohort study of 87 patients with relapsing-remitting MS originally included in a randomized placebo-controlled trial of omega-3 fatty acids in MS (the OFAMS Study). Serum levels of cotinine (biomarker of tobacco use) were analyzed at baseline and every 6 months for 2 years. MRI activity was assessed at baseline and monthly for 9 months and after 12 and 24 months. Results: Fifty-three patients (61%) had serum cotinine levels ≥85 nmol/L on ≥60% of the measurements and were considered tobacco users and 34 (39%) had cotinine levels <85 nmol/L, consistent with non–tobacco use. There was no association between tobacco use and the occurrence of new gadolinium-enhancing T1 lesions, new or enlarging T2 lesions, or their aggregate (combined unique activity). Furthermore, there was no association between cotinine levels and MRI activity for the tobacco users, and tobacco users did not have more relapses or Expanded Disability Status Scale progression. Conclusion: Our results indicate that tobacco use does not directly influence MRI activity or relapse rate in MS. This may implicate that the reported association between smoking and MS disease progression could be mediated through other mechanisms. PMID:27458599
Surani, Nikita Shiraz; Shroff, Hemal Pereira
The objectives of this study were to explore differences in exposure to media messages (pro- and antitobacco messages, marketing and promotions) between students consuming tobacco, areca nut, nonconsumers, and those intending to quit and to examine differences between municipal and private school students. The Global Youth Tobacco Survey was completed by secondary school students (N = 534) from municipal and private schools in Mumbai. Overall, the number of students who reported ever use of tobacco was quite low (5.1%). There was no significant difference in exposure to media messages between users of tobacco, areca nut, and nonusers. There were significantly higher numbers of ever users of tobacco in private compared to municipal schools. There was a significant association between exposure to marketing and promotions and intention to quit, but not with the other exposure variables. Media exposure may be related to intention to quit but not to quitting behavior.
Genotoxicity of Tobacco Smoke and Tobacco Smoke Condensate: A Review
This report reviews the literature on the genotoxicity of main-stream tobacco smoke and cigarette smoke condensate (CSC) published since 1985. CSC is genotoxic in nearly all systems in which it h...
Sebrie, E; Barnoya, J; Perez-Stable, E; Glantz, S
Objective: To evaluate how transnational tobacco companies, working through their local affiliates, influenced tobacco control policymaking in Argentina between 1966 and 2005. Methods: Analysis of internal tobacco industry documents, local newspapers and magazines, internet resources, bills from the Argentinean National Congress Library, and interviews with key individuals in Argentina. Results: Transnational tobacco companies (Philip Morris International, British American Tobacco, Lorillard, and RJ Reynolds International) have been actively influencing public health policymaking in Argentina since the early 1970s. As in other countries, in 1977 the tobacco industry created a weak voluntary self regulating code to avoid strong legislated restrictions on advertising. In addition to direct lobbying by the tobacco companies, these efforts involved use of third party allies, public relations campaigns, and scientific and medical consultants. During the 1980s and 1990s efforts to pass comprehensive tobacco control legislation intensified, but the organised tobacco industry prevented its enactment. There has been no national activity to decrease exposure to secondhand smoke. Conclusions: The tobacco industry, working through its local subsidiaries, has subverted meaningful tobacco control legislation in Argentina using the same strategies as in the USA and other countries. As a result, tobacco control in Argentina remains governed by a national law that is weak and restricted in its scope. PMID:16183967
Hahn, Ellen J.; Rayens, Mary Kay; Rasnake, Rob; York, Nancy; Okoli, Chizimuzo T.C.; Riker, Carol A.
This study examined factors associated with tobacco-free policies and tobacco cessation in schools serving children in grades 6 to 12 in a tobacco-growing state using a cross-sectional telephone survey of school administrators from public and private middle and high schools (N = 691), representing 117 of the 120 Kentucky counties. Trained health…
Hammond, David; Costello, Mary-Jean; Fong, Geoffrey T.; Topham, Jennifer
Objectives: To examine the salience of tobacco marketing on postsecondary campuses and student support for tobacco control policies. Methods: Face-to-face surveys were conducted with 1690 students at 3 universities in southwestern Ontario. Results: Virtually all (97%) students reported noticing tobacco marketing in the past year, and 35% reported…
Richter, Patricia; Spierto, Francis W
Smokeless tobacco is a complex chemical mixture, including not only the components of the tobacco leaf but also chemicals added during the manufacturing process. Smokeless tobacco contains the addictive chemical nicotine and more than 20 cancer-causing chemicals, including the potent tobacco-specific nitrosamines. The National Toxicology Program of the National Institutes of Health has concluded that oral use of smokeless tobacco is a human carcinogen. Therefore, smokeless tobacco is not a safe alternative to cigarettes. In fact, smokeless tobacco use begins primarily during early adolescence and can lead to nicotine dependence and increased risk of becoming a cigarette smoker. Under the Comprehensive Smokeless Tobacco Health Education Act of 1986 (15 U.S.C. 4401 et seq., Pub. L. 99-252), tobacco manufacturers report annually to the Centers for Disease Control and Prevention (CDC) on the total nicotine, unprotonated nicotine, pH, and moisture content of their smokeless tobacco products. This information is considered "trade secret," or confidential, in accordance with 5 U.S.C. 552(b)(4) and 18 U.S.C. 1905 and cannot be released to the public. In an effort to provide consumers and researchers with information on the nicotine content of smokeless tobacco, CDC arranged for the analysis of popular brands of smokeless tobacco. The results of this CDC study show that pH is a primary factor in the amount of nicotine that is in the most readily absorbable, unprotonated form. Furthermore, this study found that the brands of moist snuff smokeless tobacco with the largest amount of unprotonated nicotine also are the most frequently sold brands.
Morrow, Martha; Barraclough, Simon
Gender is a key but often overlooked--determinant of tobacco use, especially in Asia, where sex-linked differences in prevalence rates are very large. In this article we draw upon existing data to consider the implications of these patterns for gender equity and propose approaches to redress inequity through gender-sensitive tobacco control activities. International evidence demonstrates that, in many societies, risk behaviours (including tobacco use) are practised substantially more by men and boys, and are also viewed as expressions of masculine identity. While gender equity focuses almost exclusively on the relative disadvantage of girls and women that exists in most societies, disproportionate male use of tobacco has profound negative consequences for men (as users) and for women (nonusers). Surprisingly, health promotion and tobacco control literature rarely focus on the role of gender in health risks among boys and men. However, tobacco industry marketing has masterfully incorporated gender norms, and also other important cultural values, to ensure its symbols are context-specific. By addressing gender-specific risks within the local cultural context--as countries are enjoined to do within the Framework Convention's Guiding Principles--it may be possible to accelerate the impact of mechanisms such as tobacco pricing, restrictions on marketing, smoking bans and provision of accurate information. It is essential that we construct a new research-to-policy framework for gender-sensitive tobacco control. Successful control of tobacco can only be strengthened by bringing males, and the concept of gender as social construction, back into our research and discussion on health and gender equity.
... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Processed tobacco. 40.257 Section 40.257 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES,...
... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Processed tobacco. 40.257 Section 40.257 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES,...
... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Processed tobacco. 40.257 Section 40.257 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES,...
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Processed tobacco. 40.257 Section 40.257 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES,...
... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Processed tobacco. 40.257 Section 40.257 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES,...
Nurwidya, Fariz; Takahashi, Fumiyuki; Baskoro, Hario; Hidayat, Moulid; Yunus, Faisal; Takahashi, Kazuhisa
Tobacco consumption is a major causative agent for various deadly diseases such as coronary artery disease and cancer. It is the largest avoidable health risk in the world, causing more problems than alcohol, drug use, high blood pressure, excess body weight or high cholesterol. As countries like Indonesia prepare to develop national policy guidelines for tobacco harm reduction, the scientific community can help by providing continuous ideas and a forum for sharing and distributing information, drafting guidelines, reviewing best practices, raising funds, and establishing partnerships. We propose several strategies for reducing tobacco consumption, including advertisement interference, cigarette pricing policy, adolescent smoking prevention policy, support for smoking cessation therapy, special informed consent for smokers, smoking prohibition in public spaces, career incentives, economic incentives, and advertisement incentives. We hope that these strategies would assist people to avoid starting smoking or in smoking cessation.
Miao, Shida; Beach, Evan S.; Sommer, Toby J.; Zimmerman, Julie B.
Introduction: Sweeteners in tobacco products may influence use initiation and reinforcement, with special appeal to adolescents. Recent analytical studies of smokeless tobacco products (snuff, snus, dissolvables) detected flavorants identical to those added to confectionary products such as hard candy and chewing gum. However, these studies did not determine the levels of sweeteners. The objective of the present study was to quantify added sweeteners in smokeless tobacco products, a dissolvable product, electronic cigarette liquids and to compare with sweetener levels in confectionary products. Methods: Sweetener content of US-sourced smokeless tobacco, electronic cigarette liquid, and confectionary product samples was analyzed by liquid chromatography-electrospray ionization–mass spectrometry (LC-ESI-MS). Results: All smokeless products contained synthetic high intensity sweeteners, with snus and dissolvables exceeding levels in confectionary products (as much as 25-fold). All snus samples contained sucralose and most also aspartame, but no saccharin. In contrast, all moist snuff samples contained saccharin. The dissolvable sample contained sucralose and sorbitol. Ethyl maltol was the most common sweet-associated component in electronic cigarette liquids. Discussion: Sweetener content was dependent on product category, with saccharin in moist snuff, an older category, sucralose added at high levels to more recently introduced products (snus, dissolvable) and ethyl maltol in electronic cigarette liquid. The very high sweetener concentrations may be necessary for the consumer to tolerate the otherwise aversive flavors of tobacco ingredients. Regulation of sweetener levels in smokeless tobacco products may be an effective measure to modify product attractiveness, initiation and use patterns. Implications: Dissolvables, snus and electronic cigarettes have been promoted as risk-mitigation products due to their relatively low content of nitrosamines and other tobacco
Ayo-Yusuf, Olalekan A; Olutola, Bukola G; Agaku, Israel T
School personnel, who are respected members of the community, may exert significant influence on policy adoption. This study assessed the impact of school personnel's permissiveness toward tobacco industry sponsorship activities on their support for complete bans on tobacco advertisements, comprehensive smoke-free laws and increased tobacco prices. Representative data were obtained from the Global School Personnel Survey for 29 African countries (n = 17 929). Adjusted prevalence ratios (aPR) were calculated using multi-variable Poisson regression models to assess the impact of permissiveness toward tobacco sponsorship activities on support for tobacco control policies (p < 0.05). The median of prevalence of support for different tobacco control policies among all countries was as follows: complete ban on tobacco advertisements (84.9%); comprehensive smoke-free laws (92.4%) and tobacco price increases (80.8%). School personnel who believed that the tobacco industry should be allowed to sponsor school events were significantly less likely to support complete bans on tobacco advertisements [aPR = 0.89; 95% confidence interval (CI) 0.84-0.95] and comprehensive smoke-free laws (aPR = 0.95; 95% CI 0.92-0.98). In contrast, support for complete tobacco advertisement bans was more likely among those who believed that the tobacco industry encourages youths to smoke (aPR = 1.27; 95% CI 1.17-1.37), and among those who taught about health sometimes (aPR = 1.06; 95% CI 1.01-1.11) or a lot (aPR = 1.05; 95% CI 1.01-1.10) compared with those who did not teach about health at all. These findings underscore the need to educate school personnel on tobacco industry's strategies to undermine tobacco control policies. This may help to build school personnel support for laws intended to reduce youth susceptibility, experimentation and established use of tobacco products.
O'Connor, Richard J; McNeill, Ann; Borland, Ron; Hammond, David; King, Bill; Boudreau, Christian; Cummings, K Michael
Most tobacco control efforts in western countries focus on the factory-made, mass-produced (FM) cigarette, whereas other tobacco products receive relatively little attention. Noncombusted tobacco products (i.e., referred to as smokeless tobacco), particularly Swedish-style snus, carry lower disease risks, compared with combusted tobacco products such as cigarettes. In this context, it is important to know what tobacco users believe about the relative harmfulness of various types of tobacco products. Data for this study came from random-digit-dialed telephone surveys of current smokers aged 18 or older in Australia, Canada, the United Kingdom, and the United States. Three waves of data, totaling 13,322 individuals, were assessed. Items assessed use of and beliefs about the relative harms of cigars, pipes, smokeless tobacco, and FM and roll-your-own cigarettes, as well as sociodemographics and smoking behaviors. Cigars (2.8%-12.7%) were the other tobacco products most commonly used by current cigarette smokers, followed by pipes (0.3%-2.1%) and smokeless tobacco (0.0%-2.3%). A significant minority of smokers (12%-21%) used roll-your-own cigarettes at least some of the time. About one-quarter of smokers believed that pipes, cigars, or roll-your-own cigarettes were safer than FM cigarettes, whereas only about 13% responded correctly that smokeless tobacco was less hazardous than cigarettes. Multivariate analyses showed that use of other tobacco products was most strongly related to beliefs about the reduced harm of these other products. Use of other tobacco products was low but may be growing among smokers in the four countries studied. Smokers are confused about the relative harms of tobacco products. Health education efforts are needed to correct smoker misperceptions.
Bryant, Lawrence O.; Bowman, Lorenzo
This chapter addresses tobacco use among sexual minorities. It examines research on the prevalence of tobacco use in the lesbian, gay, bisexual, and transgender (LGBT) community and discusses why tobacco use within this group continues to significantly exceed that of the general population.
large epidemiological studies have examined to- bacco use among adolescents or young adults, and some have presented their results in sufficient detail...in the Marine Corps. Tobacco is prohibited during basic training, but relapse is common following boot camp graduation. The objective of this study ...15,689 male Marine Corps recruits participated in the study . All were either E1 or E2 privates, with a mean age of 19.5 years. Approximately 16.5% were
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Pipe tobacco and roll-your-own tobacco tax rates. 41.30 Section 41.30 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO...
... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Pipe tobacco and roll-your-own tobacco tax rates. 41.30 Section 41.30 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO...
... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Record of tobacco and processed tobacco. 40.182 Section 40.182 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS,...
... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Pipe tobacco and roll-your-own tobacco tax rates. 41.30 Section 41.30 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO...
... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Pipe tobacco and roll-your-own tobacco tax rates. 41.30 Section 41.30 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO...
... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Pipe tobacco and roll-your-own tobacco tax rates. 41.30 Section 41.30 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO...
... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Record of tobacco and processed tobacco. 40.182 Section 40.182 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS,...
Congress passed the Family Smoking Prevention and Tobacco Control Act in 2009 with the aim of reducing tobacco-related illnesses and deaths by curbing tobacco's appeal to and use by children and adolescents. Legislators considered provisions of the FSPTCA restricting tobacco advertising and labeling key to realizing the law's intended health benefits. But a lawsuit now before the U.S. Court of Appeals for the Sixth Circuit challenges the tobacco marketing restrictions as impermissible restraints on tobacco companies' commercial speech rights under the First Amendment. This article analyzes the constitutionality of each FSPTCA tobacco advertising and labeling restriction in light of U.S. Supreme Court decisions defining the extent of First Amendment protection for commercial speech, prior efforts to restrict tobacco marketing, and the outcomes of legal challenges to some of the prior marketing restrictions. Several of the FSPTCA tobacco advertising and labeling restrictions were drafted with insufficient accommodations for tobacco companies' First Amendment right to convey and consumers' First Amendment right to receive truthful information about lawful tobacco products and are therefore unconstitutional as currently written.
Fu, Qiang; Vaughn, Michael G
While there has been an escalating trend in the number of smokeless tobacco uses, mainly snuff, in the United States, it is unclear whether smokeless tobacco users are a homogenous class. The present investigation examines this question and identifies subtypes of smokeless tobacco users in order to better understand the characteristics of these individuals and guide appropriate intervention. Data on smokeless tobacco users (N = 2504) derived from the National Epidemiologic Survey on Alcohol and Related Conditions was employed. A range of antisocial behaviors, from reflecting non-violent deviant acts, irresponsibility, and a disengaged lifestyle, to aggression and violence were used to estimate the number of subtypes of smokeless tobacco users using latent class analysis. Four latent classes emerged: Normative Class (50.2 %), Deviant Class (21.9 %), Disengaging Class (17.2 %), and Antisocial Class (10.5 %). Logistic regression shows that major depression, alcohol use disorder, and marijuana use disorder were associated with Deviant Class (OR's from 2.0 to 10.5). The same array of psychiatric disorders and general anxiety disorder were associated with greater odds of membership in the Disengaging Class (OR's from 2.6 to 7.4). Aforementioned psychiatric disorders and illicit drug use disorder were associated with the Antisocial Class (OR's from 3.8 to 38.1). Findings indicate that smokeless tobacco users are a heterogeneous population that may benefit from differential intervention strategies.
Kumar, Sandeep; Dwivedi, Varsha; Pandey, Upendra; Bala, Nidhi; Vasandani, Sheela; Singh, Kamlesh; Chaudhry, Kishore
Background The finite details of tobacco consumption practices in north Indian population are hitherto not well described. This study depicts the modes of tobacco use, their relative frequency, demographic and psychosocial determinants. Materials and Methods Random stratified sampling from the list of blocks, villages and urban localities was done. The study was community-based house-to-house survey using interview schedule. Results There were 1607 tobacco users: 1399 male and 208 female; 1195 urban and 412 rural. Single mode of tobacco use was reported by 769 (47.85%). Chewing tobacco was prevalent in 511 (31.80%), smoking in 258 (16.55%) subjects and majority 838 (52.15%) had consistent multiple habit of smoking and chewing. Of the 10 preparations of tobacco use, the ‘top 5’ ranked as tobacco-betel, gutka, cigarette, bidi and khaini. Gutka consumption was significantly higher between age group of 25 years and 55 years (χ2 = 17.2; P<0.000). Majority of users, 576 (35.84%), started tobacco before 25 years of age and about a fifth, 439 (27.32%) before 18 years. Men significantly used tobacco more than women (χ2 = 73.2; P<0.000). Women (χ2 = 73.2; P<0.000) preferred smokeless tobacco and perceived social barrier for smoking. Conclusion Multiple or overlapping tobacco practices and other substances abuse were documented in Lucknow, the capital city of the most populous state Uttar Pradesh where chewing tobacco was the commonest as opposed to smoking. PMID:25756014